Individual
TARA MARIE NUZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
80 BROAD ST, CHARLESTON, SC 29401-2901
(864) 408-9509
Mailing address
15303 SWEET PL, CHARLESTON, SC 29492-2833
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5080
SC
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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