Individual
ANDREA TIVOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
87462 EDSEN CT, LANCASTER, SC 29720-6433
(910) 263-6139
Mailing address
87462 EDSEN CT, LANCASTER, SC 29720-6433
(910) 263-6139
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15809
NC
225X00000X
Occupational Therapist
6779
SC
Other
Enumeration date
09/07/2024
Last updated
11/03/2024
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