Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 9688 | NC |
NPI | 1013247428 |
---|---|
Provider Name | Marcie A Siebert |
First Address | Charlotte, NC 28209-2290 |
Second Address | Charlotte, NC 28207-1101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2010 |
Last Update Date | 05/03/2018 |