Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5886 | NC |
NPI | 1508018292 |
---|---|
Provider Name | Miss Shannon Nicole Orawiec |
First Address | Raleigh, NC 27616-2815 |
Second Address | Raleigh, NC 27616-2815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2008 |
Last Update Date | 14/10/2008 |