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Individual

RAVEN ELEXIS WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L, CNA, CMT

Contact information

Practice address
157 HOME AVE, DARLINGTON, SC 29532-7625
(843) 393-2867
Mailing address
316 FOXWORTH ST, SUMTER, SC 29150-6322
(803) 972-0032

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5175
SC
376K00000X
Nurse's Aide
560347
SC

Other

Enumeration date
10/16/2020
Last updated
10/16/2020
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