Individual
NAN MEANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
491 HIGHWAY 17, LITTLE RIVER, SC 29566-8082
(843) 399-5662
Mailing address
491 HIGHWAY 17, LITTLE RIVER, SC 29566-8082
(843) 399-5662
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC000666L
PA
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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