Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 6979 | NC |
NPI | 1003066820 |
---|---|
Provider Name | Mrs. Cassandra Maria Spivey-Johnson |
First Address | Cary, NC 27511-3202 |
Second Address | Raleigh, NC 27614-7772 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2008 |
Last Update Date | 07/10/2011 |