Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 4055 | NC |
NPI | 1023264355 |
---|---|
Provider Name | Christy Daniel |
First Address | Waxhaw, NC 28173-7271 |
Second Address | Waxhaw, NC 28173-7271 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 31/12/2020 |