Provider Demographics
NPI:1134771546
Name:SCHWARK, PATRICIA GRACE (OT/L)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GRACE
Last Name:SCHWARK
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:GRACE
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/L
Mailing Address - Street 1:4924 HOLLAND CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-9729
Mailing Address - Country:US
Mailing Address - Phone:919-896-2249
Mailing Address - Fax:919-882-8066
Practice Address - Street 1:4924 HOLLAND CHURCH RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-9729
Practice Address - Country:US
Practice Address - Phone:919-896-2249
Practice Address - Fax:919-882-8066
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist