Provider Demographics
NPI:1033480041
Name:MCHONE, BILLY CHAD (COTA)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:CHAD
Last Name:MCHONE
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 LONGMONT DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7790
Mailing Address - Country:US
Mailing Address - Phone:336-406-8429
Mailing Address - Fax:
Practice Address - Street 1:511 WINDMILL ST
Practice Address - Street 2:
Practice Address - City:WALNUT COVE
Practice Address - State:NC
Practice Address - Zip Code:27052-7706
Practice Address - Country:US
Practice Address - Phone:336-591-7357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4475224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant