Provider Demographics
NPI: | 1477102879 |
---|---|
Name: | DAVIS, APRYL N (OTA/L, BS, OT/S) |
Entity Type: | Individual |
Prefix: | |
First Name: | APRYL |
Middle Name: | N |
Last Name: | DAVIS |
Suffix: | |
Gender: | F |
Credentials: | OTA/L, BS, OT/S |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 4307 HUBBARD FALLS DRIVE |
Mailing Address - Street 2: | |
Mailing Address - City: | CHARLOTTE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28269 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 704-951-7157 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3020-I PROSPERITY CHURCH RD. |
Practice Address - Street 2: | |
Practice Address - City: | CHARLOTTE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28269 |
Practice Address - Country: | US |
Practice Address - Phone: | 704-951-7157 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2019-09-09 |
Last Update Date: | 2019-09-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 4949 | 224ZL0004X, 224ZR0403X, 224Z00000X, 224ZE0001X, 224ZF0002X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | ||
No | 224ZL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Low Vision | Group - Multi-Specialty |
No | 224ZR0403X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Driving and Community Mobility | Group - Multi-Specialty |
No | 224ZE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Environmental Modification | Group - Multi-Specialty |
No | 224ZF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Feeding, Eating & Swallowing | Group - Multi-Specialty |