Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 6794 | NC |
NPI | 1689984445 |
---|---|
Provider Name | Mrs. Shannon Windmeyer |
First Address | Cary, NC 27519 |
Second Address | Cary, NC 27519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2010 |
Last Update Date | 14/10/2010 |