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Individual

MISS MARY LEE POOLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
396 ELEMENTARY DR, EC SERVICES, FAYETTEVILLE, NC 28301-6267
(910) 678-2789
(910) 678-2793
Mailing address
396 ELEMENTARY DR, EC SERVICES, FAYETTEVILLE, NC 28301-6267
(910) 678-2789
(910) 678-2793

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4511
NC

Other

Enumeration date
10/25/2006
Last updated
07/08/2007
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