Individual
MARIAH ELISABETH VANSTAALDUINEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
611 E 12TH ST, WASHINGTON, NC 27889-3408
(252) 944-3410
Mailing address
755 BREEZY SHORE RD, BATH, NC 27808-9598
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10644
NC
Other
Enumeration date
08/30/2018
Last updated
10/26/2023
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