Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 9606 | NC |
NPI | 1073080149 |
---|---|
Provider Name | Loy Anne Campbell |
First Address | Burlington, NC 27215-6323 |
Second Address | Hillsborough, NC 27278 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2018 |
Last Update Date | 26/10/2018 |