Provider Demographics
NPI:1225929995
Name:METZGER, MARIAH (MS, CSCS)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:METZGER
Suffix:
Gender:F
Credentials:MS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3932 EDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-5518
Mailing Address - Country:US
Mailing Address - Phone:704-989-3829
Mailing Address - Fax:
Practice Address - Street 1:10820 INDEPENDENCE POINTE PKWY STE A
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2764
Practice Address - Country:US
Practice Address - Phone:704-989-3829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7248399770225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner