Individual
EMILY NILSSON BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
55 HOLCOMBE RD, LYMAN, SC 29365-9639
(864) 612-1801
Mailing address
55 HOLCOMBE RD, LYMAN, SC 29365-9639
(864) 580-9186
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2912
SC
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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