Organization
FIRM FOUNDATIONS PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA HALL YOUNT OTR/L (OCCUPATIONAL THERAPIST)
(803) 460-4655
Entity
Organization
Contact information
Practice address
116 MAIN ST, SUMMERTON, SC 29148-6904
(803) 460-4655
Mailing address
1271 COTTAGE DR, SUMMERTON, SC 29148-7008
(803) 460-4655
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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