Healthcare Provider Details

I. General information

NPI: 1053466417
Provider Name (Legal Business Name): DANIELLE PERUGINI MOT, OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GALLBERRY LN
WAXHAW NC
28173-0161
US

IV. Provider business mailing address

8801 CHINABERRY LN
CONCORD NC
28027-7537
US

V. Phone/Fax

Practice location:
  • Phone: 631-235-9787
  • Fax:
Mailing address:
  • Phone: 631-235-9787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7537
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: