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Organization
HOMEGROWN PEDIATRIC THERAPY, LLC
Active
Organization
HOMEGROWN PEDIATRIC THERAPY, LLC
Active
Other names
Home Grown Pediatric Therapy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY S LOGAN COTA (OWNER)
(843) 432-6791
Entity
Organization
Contact information
Practice address
1428 CRAB APPLE LN, HARTSVILLE, SC 29550-8258
(843) 432-6791
(888) 388-0830
Mailing address
1428 CRAB APPLE LN, HARTSVILLE, SC 29550-8258
(843) 432-6791
(888) 388-0830
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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