Sharon Darlene Wagner
Individual provider Active NPI Occupational Therapy Assistant · King, NC
NPI 1124581855 · NPPES record last updated Apr 10, 2019
Key facts
- NPI
- 1124581855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 11693 (NC)
- Practice address
- 440 Ingram Dr
King, NC 27021-8208 - Phone
- (336) 983-4900
- NPI assigned
- Apr 10, 2019
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 11693 | NC | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 11693 | NC | Yes |
Addresses
Primary practice location
440 Ingram Dr
King, NC 27021-8208
Mailing address
PO Box 167
Pine Hall, NC 27042-0167
Phone (336) 750-7410
Other providers in King, NC
- Universal Health Care / King, Inc
- Calvin Douglas Vandergrift
- Village Care of King, LLC
- Visionaires Solutions Inc.
- Lori McCombs Wade
- Wake Forest University Baptist Medical Center Community Physicians
- Wake Forest University Baptist Medical Center Community Physicians
- Wake Forest University Health Sciences
- Wal-Mart Stores East LP
- Wal-Mart Stores East, LP
All providers in King, NC · Occupational Therapy Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.