Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 11013 | NC |
NPI | 1023772605 |
---|---|
Provider Name | Elizabeth Aden Hartley |
First Address | New Bern, NC 28560-8015 |
Second Address | New Bern, NC 28560-6778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2021 |
Last Update Date | 28/10/2021 |