Individual
CRYSTAL RAE CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
200 WELLMORE DR, LEXINGTON, SC 29072-9157
(803) 500-1194
Mailing address
200 WELLMORE DR, LEXINGTON, SC 29072-9157
(803) 500-1194
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3444
SC
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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