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Individual

CAROLINE HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
240 CRIMSON OAK DR, LEXINGTON, SC 29072-8181
(903) 249-9011

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5965
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
118983
TEXAS BOARD OF OCCUPATIONAL THERAPY PRACTITIONERS
TX
01
397011
NATIONAL BOARD OF OCCUPATIONAL THERAPY
01
5965
SOUTH CAROLINE BOARD OF OCCUPATIONAL THERAPY
SC
Enumeration date
06/06/2021
Last updated
06/06/2021
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