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Organization
BLUFFTON CRANIOSACRAL & TONGUE TIE THERAPY, LLC
Active
Organization
BLUFFTON CRANIOSACRAL & TONGUE TIE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKOLE WILLMAN OTR/L (OWNER)
(631) 897-7038
Entity
Organization
Contact information
Practice address
172 FLATWATER DR, BLUFFTON, SC 29910-9348
(631) 897-7038
Mailing address
172 FLATWATER DR, BLUFFTON, SC 29910-9348
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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