Provider Demographics
NPI:1245564061
Name:STURDIVANT, ANARTHESIA RENE (OTR)
Entity Type:Individual
Prefix:MS
First Name:ANARTHESIA
Middle Name:RENE
Last Name:STURDIVANT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:ANARTHESIA
Other - Middle Name:STURDIVANT
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:316 PEIGLER ST NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-0785
Mailing Address - Country:US
Mailing Address - Phone:704-475-2652
Mailing Address - Fax:
Practice Address - Street 1:5151 SARDIS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-5291
Practice Address - Country:US
Practice Address - Phone:704-365-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6393225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist