Individual
TRACEE S OKODUWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
(704) 824-3999
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3131
SC
225X00000X
Occupational Therapist
Primary
6082
NC
Other
Enumeration date
02/11/2011
Last updated
10/05/2021
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