Individual
ANDREA THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
204 SHADY PINES CT, FOUNTAIN INN, SC 29644-9785
(864) 408-9509
(864) 335-9036
Mailing address
PO BOX 1312, FOUNTAIN INN, SC 29644-1054
(864) 408-9509
(864) 335-9036
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3732
SC
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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