Individual
LORRAINE SULLIVAN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
HANNA PAMPLICO ELEMENTARY SCHOOL, 2131 SOUTH PAMPLICO HIGHWAY, PAMPLICO, SC 29583
(843) 493-5588
Mailing address
2129 WILLOW CREEK RD, EFFINGHAM, SC 29541-3630
(843) 618-0698
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1319
SC
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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