Healthcare Provider Details

I. General information

NPI: 1720274954
Provider Name (Legal Business Name): TERESA BUSAM JONES OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA BUSAM OTR

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 FAYETTEVILLE ST
DURHAM NC
27707-4714
US

IV. Provider business mailing address

511 CLEVELAND ST
DURHAM NC
27701-3334
US

V. Phone/Fax

Practice location:
  • Phone: 919-560-3988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6583
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: