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Individual

MRS. KELLY MACINTIRE PRATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
29 N ACADEMY ST, GREENVILLE, SC 29601-2629
(864) 331-1364
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5148
SC
225XP0200X
Pediatric Occupational Therapist
5148
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TH3181
SC
Enumeration date
12/18/2017
Last updated
06/22/2022
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