Individual
MS. ARDIANNE VALORIE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
405 WAKE ROBIN CT, FLORENCE, SC 29505-3189
(843) 678-9813
Mailing address
1125 HAWKINS LANDING RD, EFFINGHAM, SC 29541-3841
(843) 624-3146
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2524
SC
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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