Individual
CARISSA GRANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1873 N PARIS AVE, PORT ROYAL, SC 29935-2029
(843) 815-6999
Mailing address
29 PLANTATION PARK DR STE 403, BLUFFTON, SC 29910-9006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT01500
RI
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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