Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 6319 | NC |
NPI | 1013156009 |
---|---|
Provider Name | Casey Johnson |
First Address | Raleigh, NC 27609-7340 |
Second Address | Raleigh, NC 27609-7340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2009 |
Last Update Date | 13/02/2009 |