Healthcare Provider Details

I. General information

NPI: 1356582696
Provider Name (Legal Business Name): EMILY MARIE MCGINTY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 WOODBYNE LN
LAUREL PARK NC
28739-0902
US

IV. Provider business mailing address

204 WOODBYNE LN
LAUREL PARK NC
28739-0902
US

V. Phone/Fax

Practice location:
  • Phone: 228-238-4340
  • Fax:
Mailing address:
  • Phone: 228-238-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number14058
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: