Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 3077 | NC |
NPI | 1164497244 |
---|---|
Provider Name | Rebecca Irene Walls |
First Address | Raleigh, NC 27604-1932 |
Second Address | Raleigh, NC 27609-6842 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 08/07/2007 |