Individual
MISS REBECCA LANELLE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1248 N LONGSTREET ST, KINGSTREE, SC 29556-2748
(843) 354-7529
(843) 382-7542
Mailing address
109 WHITESVILLE RD, MONCKS CORNER, SC 29461-2626
(843) 729-1605
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3394
SC
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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