Individual
MONA SMITH BASILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5101 PROSPERITY CHURCH RD, CHARLOTTE, NC 28269-8732
(704) 548-9111
Mailing address
549 GEORGETOWN DR NW, CONCORD, NC 28027-6463
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5477
NC
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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