Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 2170 | NC |
NPI | 1124396817 |
---|---|
Provider Name | Ms. Rae-Lynn Ziegler |
First Address | Wake Forest, NC 27587-7379 |
Second Address | Wake Forest, NC 27587-7379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2011 |
Last Update Date | 08/12/2011 |