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Individual

MS. ROXANNA LEE GRIMALDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
4501 OLD SPARTANBURG RD STE 7, TAYLORS, SC 29687-4105
(864) 292-5154
Mailing address
4501 OLD SPARTANBURG RD STE 7, TAYLORS, SC 29687-4105
(864) 292-5154
(864) 292-5151

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3525
SC
225XP0200X
Pediatric Occupational Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467469635
SC
05
225XPO200X
SC
Enumeration date
08/01/2006
Last updated
10/02/2018
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