Individual
MARIELLE CELESTE FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1563 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4248
(843) 277-2411
Mailing address
1563 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4248
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.5746
SC
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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