Individual
KATIE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1170 FOLLY RD, CHARLESTON, SC 29412-4114
(843) 822-2292
(888) 588-3421
Mailing address
215 PROMENADE VISTA ST APT 2136, CHARLESTON, SC 29412-5116
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497159446
—
SC
Enumeration date
03/28/2022
Last updated
03/28/2022
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