Individual
KARLY KRODELL WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
259 RIVER RIDGE WAY, SWANSEA, SC 29160-8287
(479) 445-2151
Mailing address
523 BYRON RD, COLUMBIA, SC 29209-2001
(479) 445-2151
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7542
SC
Other
Enumeration date
04/14/2025
Last updated
01/21/2026
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