Individual
JACLENE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3025 ASHLEY PHOSPHATE RD STE C1B, NORTH CHARLESTON, SC 29418-8447
(843) 568-2932
Mailing address
524 PLEASANT SIDE DR, MONCKS CORNER, SC 29461-7387
(843) 568-2932
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3060
SC
Other
Enumeration date
10/09/2016
Last updated
06/11/2025
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