Provider Demographics
NPI:1114415486
Name:LIVING WELL OCCUPATIONAL THERAPY, PLLC
Entity Type:Organization
Organization Name:LIVING WELL OCCUPATIONAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RUCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:919-928-4309
Mailing Address - Street 1:4035 YELLOWFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7189
Mailing Address - Country:US
Mailing Address - Phone:919-928-4309
Mailing Address - Fax:
Practice Address - Street 1:110 IOWA LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4493
Practice Address - Country:US
Practice Address - Phone:919-928-4309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6252225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty