Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 771 | NC |
NPI | 1023170339 |
---|---|
Provider Name | Mrs. Rebecca Sherwood Bordeaux |
First Address | Asheville, NC 28805-1335 |
Second Address | Asheville, NC 28801-1815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |