Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 14488 | NC |
NPI | 1063179190 |
---|---|
Provider Name | Ms. Abigail Marie Dougal |
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 | 23/11/2021 |
Last Update Date | 23/11/2021 |