Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 108388 | TX |
N | 225X00000X | Occupational Therapist | 2421 | WI |
Y | 225X00000X | Occupational Therapist | 2917 | NC |
N | 225X00000X | Occupational Therapist | 7290 | FL |
N | 225X00000X | Occupational Therapist | OT964 | ME |
NPI | 1003238460 |
---|---|
Provider Name | Kristy Grayson |
First Address | Raleigh, NC 27616-2815 |
Second Address | Raleigh, NC 27616-2815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2014 |
Last Update Date | 20/01/2014 |