Erica Marie O'Shall

Individual provider Active NPI Occupational Therapy Assistant · Bostic, NC

NPI 1104198639 · NPPES record last updated Jan 30, 2012

Key facts

NPI
1104198639
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
7063 (NC)
Practice address
503 South Mountain Rd
Bostic, NC 28018-0577
Phone
(321) 652-4378
NPI assigned
Jan 30, 2012
Sex
Female
Sole proprietor
Yes

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
7063NCMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 7063 NC Yes

Addresses

Primary practice location

503 South Mountain Rd
Bostic, NC 28018-0577

Mailing address

PO Box 577
Bostic, NC 28018-0577
Phone (321) 652-4378

Other providers in Bostic, NC

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

Sources for this page

Verify at the official NPI Registry.