Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 00917 | NC |
NPI | 1386116242 |
---|---|
Provider Name | Mrs. Catherine Bridgers Edwards |
First Address | Kenly, NC 27542-8377 |
Second Address | Kenly, NC 27542-8377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2018 |
Last Update Date | 17/12/2018 |