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Individual

SUSANNAH PATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
515 WARLEY ST, FLORENCE, SC 29501-5132
(843) 245-2720
Mailing address
1400 WISTERIA DR, FLORENCE, SC 29501-5647
(844) 245-2720

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4804
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000
PRIVATE PAY
Enumeration date
10/09/2018
Last updated
10/09/2018
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