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Individual

KAITLYN LAVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR

Contact information

Practice address
2387 LANTERN ST, CHARLESTON, SC 29414-4850
(317) 750-9879
Mailing address
180 PATRIOTS POINT RD APT 502, MOUNT PLEASANT, SC 29464-5437
(703) 615-1312

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
07/24/2023
Last updated
11/06/2024
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