Individual
JILLIAN ROSE FIORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1229 TOTEROS DR, WAXHAW, NC 28173-6950
(508) 737-9775
Mailing address
1229 TOTEROS DR, WAXHAW, NC 28173-6950
(508) 737-9775
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11724
NC
225X00000X
Occupational Therapist
5829
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH4207
—
SC
Enumeration date
05/21/2018
Last updated
10/07/2020
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