Individual
MRS. AMY HUBER AYCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
935 SHOTWELL RD, SUITE 103, CLAYTON, NC 27520-5595
(919) 359-0589
(919) 550-7695
Mailing address
809 SARAZEN DR, CLAYTON, NC 27527-3922
(919) 553-0972
(919) 550-7695
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1468
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1173X
BCBS
NC
05
—
7301046
—
NC
Enumeration date
03/22/2007
Last updated
07/12/2007
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