Provider Demographics
NPI:1225223027
Name:GILBREATH, MICHELE WELKER (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:WELKER
Last Name:GILBREATH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:W
Other - Last Name:REGENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3415 MELROSE ROAD
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-1634
Mailing Address - Country:US
Mailing Address - Phone:910-425-6282
Mailing Address - Fax:910-425-6554
Practice Address - Street 1:3415 MELROSE ROAD
Practice Address - Street 2:SUITE C-1
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-1634
Practice Address - Country:US
Practice Address - Phone:910-425-6282
Practice Address - Fax:910-425-6554
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2866225X00000X
OHOT.003976225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist