Provider Demographics
NPI:1144525486
Name:ANDERSON, MARCIA ELIZABETH (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ELIZABETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
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Mailing Address - Street 1:8750 CRESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RURAL HALL
Mailing Address - State:NC
Mailing Address - Zip Code:27045-9707
Mailing Address - Country:US
Mailing Address - Phone:336-642-4452
Mailing Address - Fax:336-325-3364
Practice Address - Street 1:1144 PACES PLACE RD
Practice Address - Street 2:
Practice Address - City:PINNACLE
Practice Address - State:NC
Practice Address - Zip Code:27043-8373
Practice Address - Country:US
Practice Address - Phone:336-817-1893
Practice Address - Fax:336-325-2335
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5101224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant