Individual
JESSICA SURFACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
1407 ASHLEY RIVER RD, CHARLESTON, SC 29407-5305
(843) 769-0663
(843) 769-0665
Mailing address
1407 ASHLEY RIVER RD, CHARLESTON, SC 29407-5305
(843) 769-0663
(843) 769-0665
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31004801A
IN
225X00000X
Occupational Therapist
Primary
4130
SC
225X00000X
Occupational Therapist
7273
NC
225XP0200X
Pediatric Occupational Therapist
4130
SC
Other
Enumeration date
07/06/2009
Last updated
09/18/2013
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