Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 400 | NC |
NPI | 1679898035 |
---|---|
Provider Name | Martha R Powell |
First Address | Sophia, NC 27350-8865 |
Second Address | Sophia, NC 27350-8865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 29/03/2010 |