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General NPI Number Information
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NPI Number | 1518375088
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Entity Type | Individual
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Provider Name | STEPHANIE DURBIN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 15855 WELLS HWY
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City | SENECA
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State | SC
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Zip | 29678-1078
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Country | US
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Telephone | 864-888-8886
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Fax |
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Provider Business Mailing Address
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Address Line | 334 STONEY CREEK DR
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City | CLEMSON
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State | SC
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Zip | 29631-1438
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Country | US
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Telephone | 859-653-3778
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4323
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License Number State | SC
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