Individual
KEANNA STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5910 SWEET PROSPECT RD, BLACKSTOCK, SC 29014-8631
(803) 899-3510
Mailing address
5910 SWEET PROSPECT RD, BLACKSTOCK, SC 29014-8631
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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