Healthcare Provider Details

I. General information

NPI: 1417228982
Provider Name (Legal Business Name): DEANNA MARIE SCHILL OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2012
Last Update Date: 01/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 WILORA LAKE RD
CHARLOTTE NC
28212-2833
US

IV. Provider business mailing address

907 HICKORY STICK DR
FORT MILL SC
29715-6931
US

V. Phone/Fax

Practice location:
  • Phone: 704-563-2922
  • Fax:
Mailing address:
  • Phone: 704-819-2536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number1976
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: