Individual
TERRELL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3420 HOLLOWAY ST, DURHAM, NC 27703-3522
(919) 596-9464
Mailing address
945 TANWORTH DR, RALEIGH, NC 27615-4740
(913) 549-6838
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10622
NC
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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