Individual
MS. MODESTYNE YVONNE MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
201 S HIGHLAND FOREST DR, COLUMBIA, SC 29203-1952
(803) 786-5949
Mailing address
201 S HIGHLAND FOREST DR, COLUMBIA, SC 29203-1952
(803) 786-5949
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
792
SC
Other
Enumeration date
08/23/2007
Last updated
10/11/2007
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