Individual
TRACI DOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 HORSESHOE BND, WINSTON SALEM, NC 27101-2306
(336) 306-3022
Mailing address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12766
NC
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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