Individual
KATIE PRUIKSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
511 SIERRA RIDGE CT, MOORE, SC 29369-9383
(864) 561-1002
Mailing address
511 SIERRA RIDGE CT, MOORE, SC 29369-9383
(864) 561-1002
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/01/2016
Last updated
08/01/2016
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