Justice Divine Newsome, COTA/L
NPI #1467209601 in Wake Forest, North Carolina
Provider Information
- NPI Number
- 1467209601
- Entity Type
- Individual
- Name
- Justice Divine Newsome, COTA/L
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Occupational Therapy Assistant
- Credential
- COTA/L
- Enumeration Date
- May 6, 2024
- Last Updated
- May 8, 2024
Practice Location
- Address
- 1317 LEGACY FALLS DR APT 207
- City
- Wake Forest
- State
- North Carolina
- ZIP Code
- 27587-1794
- Phone
- (910) 391-4989
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapy Assistant |
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