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General NPI Number Information
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NPI Number | 1114456837
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Entity Type | Individual
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Provider Name | SHAKILA HOLBERT OT
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Gender | Female
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 06/06/2017
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Provider Practice Location Address
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Address Line | 1820 BROOKWOOD AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-3200
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Country | US
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Telephone | 336-572-8280
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Fax | 336-570-8282
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Provider Business Mailing Address
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Address Line | 1820 BROOKWOOD AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-3200
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Country | US
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Telephone | 336-570-8280
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Fax | 336-570-8282
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 10697
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License Number State | NC
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