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1154893170
MIKENZI RIVENBARK
WILMINGTON, NC
NPI
1154893170
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: NC 11125)
Enumeration Date
2019-01-02
Last Update Date
2019-01-02
Business Address
MIKENZI RIVENBARK
1011 PORTERS NECK RD
WILMINGTON, NC 28411-9196
Phone number: 910-686-7195
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Mailing Address
MIKENZI RIVENBARK
125 SOUND VIEW DR
WILMINGTON, NC 28409-3570
Phone number:
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