Individual
MS. CYNTHIA LYNN CLUBB-CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
430 WAGNER TRL, COLUMBIA, SC 29229-7036
(803) 479-7904
Mailing address
430 WAGNER TRL, COLUMBIA, SC 29229-7036
(803) 479-7904
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
424
SC
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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