Provider Demographics
NPI:1558823609
Name:COPLEY, ANN HUNT (COTA/L)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:HUNT
Last Name:COPLEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 OLD BATH HWY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-7774
Mailing Address - Country:US
Mailing Address - Phone:252-945-7838
Mailing Address - Fax:
Practice Address - Street 1:4702 NC HIGHWAY 48
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-8505
Practice Address - Country:US
Practice Address - Phone:252-532-7736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12336224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant