Healthcare Provider Details

I. General information

NPI: 1942830062
Provider Name (Legal Business Name): JACQUELINE LEVINSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 S WALKER ST
CARY NC
27511-7770
US

IV. Provider business mailing address

370 S WALKER ST
CARY NC
27511-7770
US

V. Phone/Fax

Practice location:
  • Phone: 828-423-5948
  • Fax:
Mailing address:
  • Phone: 828-423-5948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number14361
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: