Healthcare Provider Details

I. General information

NPI: 1063322725
Provider Name (Legal Business Name): HAUS HAVEN COLLECTIVE OCCUPATIONAL THERAPY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19825B N COVE RD # 1018
CORNELIUS NC
28031-6445
US

IV. Provider business mailing address

19825B N COVE RD # 1018
CORNELIUS NC
28031-6445
US

V. Phone/Fax

Practice location:
  • Phone: 980-430-4380
  • Fax: 980-228-9453
Mailing address:
  • Phone: 980-430-4380
  • Fax: 980-228-9453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOUA SPILLMAN
Title or Position: OWNER
Credential: OTR/L, OTD
Phone: 980-430-4380