Individual
MS. JUDITH NIEBERGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA MLDT
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2196
(843) 777-2051
Mailing address
1106 BRUNWOOD DR, FLORENCE, SC 29501-5528
(843) 777-2196
(843) 777-2051
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
479
SC
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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