Healthcare Provider Details

I. General information

NPI: 1578604021
Provider Name (Legal Business Name): JAMIE BOTELHO WINELAND MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3829 FORESTVILLE RD
RALEIGH NC
27616-9537
US

IV. Provider business mailing address

110 CORNING RD
CARY NC
27518-9229
US

V. Phone/Fax

Practice location:
  • Phone: 919-261-5100
  • Fax:
Mailing address:
  • Phone: 919-538-6007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5234
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: