Individual
MICHELLE NICHOLE FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1 MARITHE CT, GREENSBORO, NC 27407-2702
(336) 852-9700
Mailing address
1 MARITHE CT, GREENSBORO, NC 27407-2702
(336) 852-9700
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13812
NC
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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