Individual
KATIE MYERS HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
575 STONEWALL JACKSON BLVD, ORANGEBURG, SC 29115-7250
(803) 531-5682
Mailing address
1437 CLANCY ROAD, MOUNT PLEASANT, SC 29466
(843) 709-3160
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2555
SC
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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