Organization
ROOTS TO THRIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASEY ANNE OHAREN (OWNER)
(843) 790-5077
Entity
Organization
Contact information
Practice address
1 10TH AVE, CHARLESTON, SC 29403-3601
(843) 790-5077
Mailing address
1 10TH AVE, CHARLESTON, SC 29403-3601
(843) 790-5077
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
09/18/2020
Last updated
09/21/2020
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