Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 5458 | NC |
NPI | 1033376645 |
---|---|
Provider Name | Serenity Lea Terpenning |
First Address | Bolivia, NC 28422-8645 |
Second Address | Wilmington, NC 28401-6613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 21/05/2008 |