| NPI | 1063774107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA GONZALES MACK Occupational Therapist 336-817-4278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: SC 3730) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-26 |