Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | ||
Y | 225XH1200X | Occupational Therapist - Hand | 0620 | NC |
NPI | 1124129952 |
---|---|
Provider Name | Robin A Southecorvo |
First Address | Asheville, NC 28803-2493 |
Second Address | Asheville, NC 28803-2493 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 12/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7302006 | (05) | NC |