Individual
BROOKE ELIZABETH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9020 SENCA DR STE 220, WILMINGTON, NC 28411-6680
(910) 443-5225
(910) 442-8372
Mailing address
9020 SENCA DR STE 220, WILMINGTON, NC 28411-6680
(910) 443-5225
(910) 442-8372
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12937
NC
Other
Enumeration date
10/19/2019
Last updated
07/17/2022
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