GRACE SLACK

CHARLOTTE, NC
NPI1588781876
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225XP0200X Occupational Therapist, Pediatrics
(Licence: NC  6575)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: SC  3233)
225X00000X Occupational Therapist
(Licence: NC  6575)
Enumeration Date2007-03-23
Last Update Date2009-09-14
Business Address
Mrs. GRACE SLACK OTR
10508 PARK RD SUITE 130
CHARLOTTE, NC 28210-8525
Phone number: 704-541-9080
Mailing Address
Mrs. GRACE SLACK OTR
5252 LAKE WYLIE RD
LAKE WYLIE, SC 29710-9181
Phone number: 803-412-7104