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NPI Code Detail

MEDICARE: MRS. OLIVIA CAROLINE VAN VOORHIS OTR

MEDICARE: MRS. OLIVIA CAROLINE VAN VOORHIS OTR
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
1225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1306565049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OLIVIA CAROLINE VAN VOORHIS OTR
Provider Business Mailing Address
First Line : 4301 AVENT FERRY RD APT 3
Second Line :
City : RALEIGH
State : NC
Zip : 27606-4765
Country : US
Telephone Number : 984-212-1237
Fax Number :
Provider Business Practice Location Address
First Line : 2320 REDBRIDGE LN
Second Line :
City : APEX
State : NC
Zip : 27502-2495
Country : US
Telephone Number : 984-212-1237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2022
Last Update Date : 08/25/2022

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