Healthcare Provider Details

I. General information

NPI: 1639623838
Provider Name (Legal Business Name): APEX OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 PERRY RD
APEX NC
27502-7702
US

IV. Provider business mailing address

PO BOX 1195
APEX NC
27502-3195
US

V. Phone/Fax

Practice location:
  • Phone: 919-446-4868
  • Fax:
Mailing address:
  • Phone: 919-446-4868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6214
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ALICIA KOLLMAR
Title or Position: OCCUPATIONAL THERAPIST, OWNER
Credential:
Phone: 919-446-4868