Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 9183 | NC |
NPI | 1104463272 |
---|---|
Provider Name | Leah Yenney Stevenson |
First Address | Rocky Mount, NC 27804-5622 |
Second Address | Wilson, NC 27896-9618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2019 |
Last Update Date | 07/12/2019 |