Healthcare Provider Details

I. General information

NPI: 1376426395
Provider Name (Legal Business Name): JENA CLINCH WOJCIK OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1367 W MARTINTOWN RD STE 1&2
NORTH AUGUSTA SC
29860-7616
US

IV. Provider business mailing address

1367 W MARTINTOWN RD STE 1&2
NORTH AUGUSTA SC
29860-7616
US

V. Phone/Fax

Practice location:
  • Phone: 803-617-7523
  • Fax: 803-386-0362
Mailing address:
  • Phone: 803-617-7523
  • Fax: 803-386-0362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5734
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: