Individual
DAWN DECOLLEWAERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2001 S 17TH ST STE 101, WILMINGTON, NC 28401-6628
(910) 763-8184
Mailing address
808 SAINT ANDREWS DR APT H, WILMINGTON, NC 28412-8358
(910) 471-3237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5510
LICENSE #
NC
Enumeration date
08/20/2006
Last updated
12/12/2014
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