Individual
MATTIE DEVIN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1801 OLD TROLLEY RD STE 203, SUMMERVILLE, SC 29485-8283
(843) 594-3032
Mailing address
1531 GATOR TRAK, CHARLESTON, SC 29414-9146
(843) 621-5210
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5164
SC
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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