Individual
BONNIE JEAN FAMOLARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1707 CRESTGATE DR, WAXHAW, NC 28173-6730
(704) 843-7751
Mailing address
1707 CRESTGATE DR, WAXHAW, NC 28173-6730
(704) 843-7751
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3282
NC
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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