Healthcare Provider Details

I. General information

NPI: 1396473815
Provider Name (Legal Business Name): HOOFPRINTS IN THE SAND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 09/11/2025
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 WANDO RD
CHARLESTON SC
29492-7854
US

IV. Provider business mailing address

8 INTRACOASTAL CT
ISLE OF PALMS SC
29451-2500
US

V. Phone/Fax

Practice location:
  • Phone: 843-364-4918
  • Fax: 843-884-4618
Mailing address:
  • Phone: 843-364-4918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH KENNERLY LUSTIG
Title or Position: REHAB NURSE DIRECTOR
Credential: RN
Phone: 843-364-4918