Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 1125 | WV |
N | 225XP0200X | Occupational Therapist - Pediatrics | 4433 | NC |
NPI | 1033583828 |
---|---|
Provider Name | Shanna Carter |
First Address | Marshall, NC 28753-5599 |
Second Address | Marshall, NC 28753-5599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2015 |
Last Update Date | 01/12/2021 |