Provider Demographics
NPI:1043264591
Name:SISK-WAMBLES, DAUPHINE P (OTDR/L)
Entity Type:Individual
Prefix:DR
First Name:DAUPHINE
Middle Name:P
Last Name:SISK-WAMBLES
Suffix:
Gender:F
Credentials:OTDR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 FIELDCREST RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2343
Mailing Address - Country:US
Mailing Address - Phone:910-494-5242
Mailing Address - Fax:
Practice Address - Street 1:255 FIELDCREST RD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2343
Practice Address - Country:US
Practice Address - Phone:910-494-5242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics