Healthcare Provider Details

I. General information

NPI: 1558087460
Provider Name (Legal Business Name): CAROLINE MARIE ZISSETTE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 TURNBURY DR
GREENVILLE NC
27858-6168
US

IV. Provider business mailing address

1925 TURNBURY DR
GREENVILLE NC
27858-6168
US

V. Phone/Fax

Practice location:
  • Phone: 252-341-9944
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number15958
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number.6658
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: