Organization
MARY ANN STANLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN STANLEY COTA (COTA)
(794) 301-9923
Entity
Organization
Contact information
Practice address
17130 KENTON DR, 316, CORNELIUS, NC 28031-5919
(794) 301-9923
Mailing address
17130 KENTON DR, 316, CORNELIUS, NC 28031-5919
(794) 301-9923
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
7944
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7944
STATE IOF NC BOARD OF OCCUPTIONAL THERAPY
NC
Enumeration date
07/20/2015
Last updated
07/20/2015
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