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General NPI Number Information
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NPI Number | 1669984779
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL WISDOM, PLLC
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 121 VAUGHN RD
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City | REIDSVILLE
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State | NC
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Zip | 27320-9253
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Country | US
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Telephone | 336-432-9533
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Fax |
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Provider Business Mailing Address
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Address Line | 121 VAUGHN RD
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City | REIDSVILLE
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State | NC
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Zip | 27320-9253
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Country | US
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Telephone | 336-432-9533
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. CONNIE BELICZKY REYNOLDS
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Credential | MS-OTR/L
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Telephone | 336-432-9533
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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 | 8184
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License Number State | NC
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