Individual
MS. HARRIETTHALL HALL WITHERSPOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
630 N FODALE AVE, 630 N FODALE AVE, SOUTHPORT, NC 28461-3538
(910) 457-4686
Mailing address
630 N FODALE AVE, SOUTHPORT, NC 28461-3538
(910) 457-4686
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
4776
NC
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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