Individual
MRS. SUSAN CARTER CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA L
Contact information
Practice address
104 WINDWOOD LN, COTA L NOT AN INDIVIDUAL BUSINESS, MONCKS CORNER, SC 29461-9418
(843) 345-7027
Mailing address
104 WINDWOOD LN, MONCKS CORNER, SC 29461-9418
(843) 345-7027
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3240
SC
Other
Enumeration date
09/14/2013
Last updated
09/14/2013
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