Individual
MONICA-HISANO GUSTAFSON GALLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3864 SWEETEN CREEK RD, ARDEN, NC 28704-3136
(828) 681-0904
Mailing address
386 DEAVERVIEW RD, ASHEVILLE, NC 28806
(828) 216-1616
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2738
ND
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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