Individual
YOLANDA MCCLOUD GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
111 WELLMORE DR, TEGA CAY, SC 29708-0124
(803) 835-7000
Mailing address
111 WELLMORE DR, TEGA CAY, SC 29708-0124
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3559
SC
Other
Enumeration date
03/10/2016
Last updated
05/20/2016
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