Individual
MRS. ALICIA MARIE LANCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, LMBT
Contact information
Practice address
379 PINEHAVEN STREET EXT, LAURENS, SC 29360-2672
(864) 984-6584
Mailing address
379 PINEHAVEN STREET EXT, LAURENS, SC 29360-2672
(864) 984-6584
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3159
SC
225700000X
Massage Therapist
6647
SC
Other
Enumeration date
02/26/2013
Last updated
02/26/2013
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