Individual
CARYN FIDALGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1002 UNITY CT, MONROE, NC 28110-7878
(704) 283-0028
Mailing address
8920 PENNEGROVE CIR, CHARLOTTE, NC 28214-8138
(813) 846-4019
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10415
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72-0132B
—
NC
Enumeration date
10/07/2016
Last updated
10/17/2024
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