Individual
MISS JACLYN K BOVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
950 TRAVELERS BLVD, SUMMERVILLE, SC 29485-8287
(843) 638-3239
Mailing address
950 TRAVELERS BLVD, SUMMERVILLE, SC 29483-3030
(843) 638-3239
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
001191
CT
224Z00000X
Occupational Therapy Assistant
Primary
3692
SC
Other
Enumeration date
09/24/2010
Last updated
10/02/2017
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