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Individual

MARIANNE PEDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
362 N PINE ST, SPARTANBURG, SC 29302-1631
(864) 398-5100
(864) 582-1996
Mailing address
8811 WARREN H ABERNATHY HWY, SPARTANBURG, SC 29301
(864) 574-7282
(864) 574-7664

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3406
SC
225XP0200X
Pediatric Occupational Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TH2172
SC
Enumeration date
11/02/2009
Last updated
10/17/2011
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