| NPI | 1003953514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA G. BEARD Member 843-708-0859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: SC 2206) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |