| NPI | 1770611402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEICO FAISON Manager 919-451-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 4761) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2012-08-06 |