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1639869613
TYWANNA SHARDAE BLACKWELL
ABBEVILLE, SC
NPI
1639869613
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: SC 5347)
Enumeration Date
2023-05-11
Last Update Date
2023-05-11
Business Address
TYWANNA SHARDAE BLACKWELL COTA/L
83 THOMSON CIR
ABBEVILLE, SC 29620-5652
Phone number: 864-366-5122
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Mailing Address
TYWANNA SHARDAE BLACKWELL COTA/L
104 OAKLAND AVE APT 1401
ABBEVILLE, SC 29620-2723
Phone number: 864-447-7111
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