Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 5056 | NC |
NPI | 1033377163 |
---|---|
Provider Name | Mrs. Elizabeth Anne Mccall |
First Address | Wilmington, NC 28405-2116 |
Second Address | Wilmington, NC 28405-2116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 27/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5056 | NC OTA LICENSE (01) | NC |