Healthcare Provider Details

I. General information

NPI: 1811548787
Provider Name (Legal Business Name): LEA TAYLOR MEEKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 EDDICE TAYLOR RD
FAISON NC
28341-8549
US

IV. Provider business mailing address

185 EDDICE TAYLOR RD
FAISON NC
28341-8549
US

V. Phone/Fax

Practice location:
  • Phone: 910-590-5770
  • Fax:
Mailing address:
  • Phone: 910-590-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11608
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: