Individual
JACQUELYN MARIE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
65 PALMETTO WOOD PKWY, IRMO, SC 29063-2880
(352) 262-3686
Mailing address
65 PALMETTO WOOD PKWY, IRMO, SC 29063-2880
(352) 262-3686
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4023
SC
Other
Enumeration date
02/26/2019
Last updated
05/17/2022
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