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General NPI Number Information
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NPI Number | 1134524259
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Entity Type | Individual
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Provider Name | RITA BRIZUELA
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Gender | Female
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 7532 WILKINS DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-9338
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Country | US
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Telephone | 336-849-4072
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Fax |
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Provider Business Mailing Address
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Address Line | 3990 BAROTON LN
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City | CLEMMONS
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State | NC
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Zip | 27012-8598
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Country | US
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Telephone | 786-683-1799
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 9404
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 14902
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License Number State | NC
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