| NPI | 1073956868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENDA JACKSON Occupational Therapy Consultative 336-624-6519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |