Healthcare Provider Details

I. General information

NPI: 1821953472
Provider Name (Legal Business Name): EMMA JANE TOBER OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85C VINCENT DR
MT PLEASANT SC
29464-4030
US

IV. Provider business mailing address

1043 FORT SUMTER DR
CHARLESTON SC
29412-4331
US

V. Phone/Fax

Practice location:
  • Phone: 843-822-2292
  • Fax:
Mailing address:
  • Phone: 703-967-7436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number7808
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: