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Individual

DANIELLE DILLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Mailing address
8627 SCENIC VIEW DR APT 2207, FORT WORTH, TX 76244-9272
(828) 455-6782

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
117043
TX
225X00000X
Occupational Therapist
Primary
5843
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5843
STATE LICENSE
SC
Enumeration date
07/14/2015
Last updated
05/28/2020
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