Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT4407 | NM |
N | 225XP0200X | Occupational Therapist - Pediatrics | 5666 | NC |
NPI | 1871706853 |
---|---|
Provider Name | M. Celeste Mcconnell |
First Address | Leland, NC 28451-1489 |
Second Address | Truth Or Consequences, NM 87901-1961 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 17/05/2021 |