Provider Demographics
NPI:1669138251
Name:RIGUERA, MARY JANE CHARLENE ATMOSFERA (COTA/L)
Entity type:Individual
Prefix:
First Name:MARY JANE CHARLENE
Middle Name:ATMOSFERA
Last Name:RIGUERA
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 1:1105 W NC HIGHWAY 54 BYP APT Y1
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2866
Mailing Address - Country:US
Mailing Address - Phone:571-830-8648
Mailing Address - Fax:
Practice Address - Street 1:100 WHIPPOORWILL LN
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8505
Practice Address - Country:US
Practice Address - Phone:919-942-4014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13876224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant