Individual
TAKIYAH GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
FT BRAGG ARMY BASE WOMACK MEDICAL, FORT BRAGG, NC 28310-0001
(910) 643-2362
Mailing address
179 BLACKHAWK LN, RAEFORD, NC 28376-8275
(803) 378-6698
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6186
NC
Other
Enumeration date
07/23/2007
Last updated
07/16/2013
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