Individual
MS. BONNIE DIANE MAYBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1501 E GREENVILLE ST, ANDERSON, SC 29621-2004
(864) 226-8356
(864) 261-6480
Mailing address
3792 HIGHWAY 29 S, ANDERSON, SC 29626-6719
(864) 964-0074
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
221
SC
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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