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Individual

MRS. CAITLIN MOORE SUND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MHS OTRL

Contact information

Practice address
10508 PARK RD, SUITE 130, CHARLOTTE, NC 28210-8405
(704) 541-9080
Mailing address
3105 WELL HOUSE CT, CHARLOTTE, NC 28210-7932
(704) 541-9080

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
11281
FL
225XP0200X
Pediatric Occupational Therapist
Primary
5695
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7301803
NC
Enumeration date
03/15/2006
Last updated
07/08/2007
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