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Individual

CARLA BLUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
170 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(704) 323-2000
Mailing address
4601 PARK RD, SUITE 300, CHARLOTTE, NC 28209-3239
(704) 323-2000

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
0348
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0348
NC BOARD OF OCCUPATIONAL THERAPY
NC
Enumeration date
11/04/2013
Last updated
06/02/2014
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