Individual
CHARLEE BLACK HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
29 N ACADEMY ST, GREENVILLE, SC 29601-2629
(864) 331-1364
Mailing address
101 SAINT LUKES CIR, EASLEY, SC 29642-7771
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4668
SC
Other
Enumeration date
02/15/2016
Last updated
03/10/2020
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