Most Relevant Information
Provider Data
| NPI Number: | 1003421876 |
| Provider Name: | ANNIE CAROLINA MCCOLLUM |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/09/2020 |
| Last Updated: | 05/05/2021 |
Provider Practice Location
4201 LAKE BOONE TRL STE 4
RALEIGH
NC
276077511
Practice Location Phone/Fax
| Phone: | 9197814434 |
| Fax: |
Provider Mailing Location
4201 LAKE BOONE TRL STE 4
RALEIGH
NC
276077511
Provider Mailing Phone/Fax
| Phone: | 9197814434 |
| Fax: |