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Individual

ALTERREASE J KORNEGAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L, BHS

Contact information

Practice address
1407 ASHLEY RIVER RD, CHARLESTON, SC 29407-5305
(843) 769-0663
(843) 769-0665
Mailing address
1407 ASHLEY RIVER RD, CHARLESTON, SC 29407-5305
(843) 769-0663
(843) 769-0665

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2856
SC

Other

Enumeration date
12/14/2011
Last updated
12/14/2011
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