Individual
MS. TALISHA SHANENA GINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1251 E HUDSON BLVD, GASTONIA, NC 28054-6102
(704) 865-5556
Mailing address
1101 HAWTHORNE LN APT 267, CHARLOTTE, NC 28205-2983
(404) 803-0541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12392
NC
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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