Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 1196 | NC |
NPI | 1144356965 |
---|---|
Provider Name | Laura Bates |
First Address | Oxford, NC 27565-0947 |
Second Address | Oxford, NC 27565-2507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141XJ | BLUE CROSS (01) | NC |