Individual
AMY PUCIATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9225 UNIVERSITY BLVD, STE E2C, NORTH CHARLESTON, SC 29406-9149
(843) 569-4546
(843) 569-4535
Mailing address
510 CECILIA COVE DR, CHARLESTON, SC 29412-4962
(207) 240-6896
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4428
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14077652
CAQH
—
05
—
TH3646
—
SC
Enumeration date
07/14/2015
Last updated
09/19/2022
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