Provider Demographics
NPI:1285210237
Name:BELJAN, JOANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:BELJAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 GLENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-2272
Mailing Address - Country:US
Mailing Address - Phone:908-268-8256
Mailing Address - Fax:
Practice Address - Street 1:1401 71ST SCHOOL RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2814
Practice Address - Country:US
Practice Address - Phone:910-867-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist