Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 11654 | NC |
NPI | 1043701915 |
---|---|
Provider Name | Brittany Moretz Howard |
First Address | Sherrills Ford, NC 28673-7865 |
Second Address | Granite Falls, NC 28630-8372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2018 |
Last Update Date | 06/09/2019 |