Healthcare Provider Details

I. General information

NPI: 1467686220
Provider Name (Legal Business Name): AUDREY HOPKINS DAVIS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 TOPAZ PLZ
DAVIDSON NC
28036-7648
US

IV. Provider business mailing address

10 S 9TH ST STE 4
NOBLESVILLE IN
46060-2631
US

V. Phone/Fax

Practice location:
  • Phone: 561-716-0804
  • Fax:
Mailing address:
  • Phone: 765-524-3946
  • Fax: 317-708-6496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTT.200179
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11153
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: