Individual
ELISA DALI FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1563 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4248
(843) 277-2411
(855) 504-4089
Mailing address
4033 HARTLAND ST, CHARLESTON, SC 29414-6095
(404) 661-7784
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7679
SC
Other
Enumeration date
07/24/2023
Last updated
09/12/2025
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