Provider Demographics
NPI:1033699897
Name:DAVES, ALLISON SOUTHARD (COTA/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:SOUTHARD
Last Name:DAVES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:ANN
Other - Last Name:SOUTHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3322 W OLD MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-8382
Mailing Address - Country:US
Mailing Address - Phone:828-371-6384
Mailing Address - Fax:
Practice Address - Street 1:3195 OLD MURPHY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7213
Practice Address - Country:US
Practice Address - Phone:828-524-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11956224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC404556OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
NC11956OtherNORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY