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Individual

JILL HAFENBREIDEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
4761 HIGHWAY 501 STE 1, MYRTLE BEACH, SC 29579-9457
(843) 236-9751
Mailing address
PO BOX 1523, LITTLE RIVER, SC 29566-1523

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
340
SC

Other

Enumeration date
10/16/2019
Last updated
10/16/2019
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