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Individual

KATHLEEN ALYSON MACCONNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,OTR/L

Contact information

Practice address
105 SOUTHERNWOOD DR, LADSON, SC 29456-3941
(843) 822-8859
Mailing address
105 SOUTHERNWOOD DR, LADSON, SC 29456-3941

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2556
SC

Other

Enumeration date
07/30/2012
Last updated
07/30/2012
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