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Individual

CARLY RAJA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
134 INFIELD CT, MOORESVILLE, NC 28117-8026
(704) 799-6824
(704) 799-6825
Mailing address
134 INFIELD CT, MOORESVILLE, NC 28117-8026
(704) 799-6824
(704) 799-6825

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10728
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1164247752
OPTUM
NC
01
1164847752
MEDCOST
NC
05
1164847752
NC
Enumeration date
03/16/2017
Last updated
03/16/2017
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