Individual
BREELYN NOEL KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
104 MAXWELL AVE STE 312, GREENWOOD, SC 29646-2641
(864) 229-7529
(864) 229-7530
Mailing address
104 MAXWELL AVE STE 312, GREENWOOD, SC 29646-2641
(864) 229-7529
(864) 229-7530
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4883
SC
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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