Individual
VENTRICE SIMONE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122
(803) 741-9090
Mailing address
1155 CLEMSON FRONTAGE RD APT 811, COLUMBIA, SC 29229-8238
(803) 971-1455
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.4902
SC
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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