Individual
JACQUELYN M KNOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
204 SHADY PINES CT, FOUNTAIN INN, SC 29644-9785
(864) 408-9509
Mailing address
650 ENTERPRISE BLVD APT 5203, CHARLESTON, SC 29492-8548
(704) 533-2395
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3752
SC
Other
Enumeration date
06/05/2020
Last updated
06/05/2020
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