Individual
AUONTWANNQUE B. R. MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3881-A LEAPHART RD., WEST COLUMBIA, SC 29169
(803) 454-6090
(803) 451-6105
Mailing address
3681 LEAPHART RD STE A, WEST COLUMBIA, SC 29169-3068
(803) 454-6090
(803) 451-6105
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2490
SC
Other
Enumeration date
10/28/2008
Last updated
06/09/2016
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