Individual
LLEWELLYN WORSHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
215 BLOSSOM ST, GOOSE CREEK, SC 29445-3516
(843) 323-0174
Mailing address
215 BLOSSOM ST, GOOSE CREEK, SC 29445-3516
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3243
SC
Other
Enumeration date
06/09/2016
Last updated
11/27/2016
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