Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1043264591 |
---|---|
Provider Name | Dr. Dauphine P. Sisk-Wambles |
First Address | Southern Pines, NC 28387-2343 |
Second Address | Southern Pines, NC 28387-2343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 03/08/2015 |