Provider Demographics
NPI:1063932630
Name:BROWN, JOANNE (COTA/L)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 SAINT ANDREWS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WOODLEAF
Mailing Address - State:NC
Mailing Address - Zip Code:27054-9757
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:877 HILL EVERHART RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-9140
Practice Address - Country:US
Practice Address - Phone:336-248-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8734225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty