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General NPI Number Information
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NPI Number | 1891127478
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Entity Type | Organization
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Legal Business Name | MISSOT PLLC
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 1414 LAUREL LN
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City | HILLSBOROUGH
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State | NC
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Zip | 27278-9456
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Country | US
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Telephone | 919-451-9636
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Fax | 919-732-2514
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Provider Business Mailing Address
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Address Line | 1414 LAUREL LN
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City | HILLSBOROUGH
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State | NC
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Zip | 27278-9456
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Country | US
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Telephone | 919-451-9636
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Fax | 919-732-2514
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | KRISTIN LAURA TITUS
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Credential | OTR/L
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Telephone | 919-451-9636
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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 | 0636
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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 | 5845
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License Number State | NC
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