Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 6679 | NC |
N | 225XH1200X | Occupational Therapist - Hand | 6679 | NC |
NPI | 1124232525 |
---|---|
Provider Name | Diane E Fiore |
First Address | Charlotte, NC 28209-2290 |
Second Address | Charlotte, NC 28207-1101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 23/08/2017 |