=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063322725
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAUS HAVEN COLLECTIVE OCCUPATIONAL THERAPY SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2026
-----------------------------------------------------
Last Update Date | 09/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19825B N COVE RD # 1018
-----------------------------------------------------
City | CORNELIUS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28031-6445
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-430-4380
-----------------------------------------------------
Fax | 980-228-9453
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19825B N COVE RD # 1018
-----------------------------------------------------
City | CORNELIUS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28031-6445
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-430-4380
-----------------------------------------------------
Fax | 980-228-9453
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. JOUA SPILLMAN
-----------------------------------------------------
Credential | OTR/L, OTD
-----------------------------------------------------
Telephone | 980-430-4380
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XE0001X
-----------------------------------------------------
Taxonomy Name | Environmental Modification Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------