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Organization

JUST FOR KIDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ANGELA NICOLE BOYD MSR, OTR/L (OWNER)
(864) 962-6832
Entity
Organization

Contact information

Practice address
11 MARTELE CT, SIMPSONVILLE, SC 29680-7615
(864) 962-6832
Mailing address
11 MARTELE CT, SIMPSONVILLE, SC 29680-7615
(864) 962-6832

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2578
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053578724
NPI
SC
01
1487735700
NPI
SC
05
889545700
FL
05
TH1231
SC
Enumeration date
09/26/2008
Last updated
07/09/2009
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