Individual
MS. BEATRICE VINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
5701 QUAIL COVEY LN, WENDELL, NC 27591-9506
(919) 413-9901
Mailing address
5701 QUAIL COVEY LN, WENDELL, NC 27591-9506
(919) 413-9901
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
02616
MD
225X00000X
Occupational Therapist
Primary
0780
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401382400
—
MD
Enumeration date
10/04/2005
Last updated
10/31/2011
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