Andrea Perkins, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Wallace, NC

NPI 1104089671 · NPPES record last updated Jul 5, 2008

Key facts

NPI
1104089671
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
3448 (NC)
Practice address
647 SE Railroad St
Wallace, NC 28466-2091
Phone
(910) 285-9710
NPI assigned
Jul 5, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3448NCMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3448 NC Yes

Addresses

Primary practice location

647 SE Railroad St
Wallace, NC 28466-2091

Mailing address

647 SE Railroad St
Wallace, NC 28466-2091
Phone (910) 285-9710

Other providers in Wallace, NC

All providers in Wallace, NC · Occupational Therapy Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.