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NPI Code Detail

MEDICARE: MICHELLE LYNN RAYMOND OTR/L

MEDICARE:   MICHELLE LYNN RAYMOND  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5681NC

General Provider Information

NPI Number : 1013288042
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE LYNN RAYMOND OTR/L
Provider Business Mailing Address
First Line : 1726 FOREST SIDE LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28213-2104
Country : US
Telephone Number : 704-877-1901
Fax Number :
Provider Business Practice Location Address
First Line : 620 TOM HUNTER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28213-5511
Country : US
Telephone Number : 704-598-5136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2012
Last Update Date : 01/23/2012

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Directions to “ MICHELLE LYNN RAYMOND OTR/L” Practice Location

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