Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 7948 | NC |
NPI | 1023409133 |
---|---|
Provider Name | Linda Bowen |
First Address | Greenville, NC 27858-9416 |
Second Address | Tarboro, NC 27886-5055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2015 |
Last Update Date | 10/02/2015 |