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Individual

LINDA AMONDI OKELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1711 CENTRAL AVE, SUMMERVILLE, SC 29483-9320
(843) 934-2697
Mailing address
1711 CENTRAL AVE, SUMMERVILLE, SC 29483-9320
(843) 934-2697

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RBT-22-243096
SC
Enumeration date
11/14/2022
Last updated
11/14/2022
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