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General NPI Number Information
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NPI Number | 1306697511
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Entity Type | Organization
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Legal Business Name | BUTTERFLY PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 814 WOODBRIDGE ST
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City | LANCASTER
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State | SC
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Zip | 29720-7738
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Country | US
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Telephone | 803-804-0879
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Fax |
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Provider Business Mailing Address
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Address Line | 814 WOODBRIDGE ST
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City | LANCASTER
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State | SC
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Zip | 29720-7738
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Country | US
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Telephone | 803-804-0879
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Fax |
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Authorized Official
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Title or Position | OTR/L/OWNER
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Name | MRS. MELISSA DANELLE COCHO-TANNER
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Credential | OTR/L
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Telephone | 803-804-0879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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