| NPI | 1114083284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE CHESSON WOLFF President 336-294-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NC 2044) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 225400000X Rehabilitation Practitioner | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 235Z00000X Speech-Language Pathologist, | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2021-03-14 |