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General NPI Number Information
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NPI Number | 1619345824
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Entity Type | Organization
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Legal Business Name | KID WORKS OCCUPATIONAL THERAPY LLC
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 1595 SAVANNAH HWY STE 3
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City | CHARLESTON
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State | SC
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Zip | 29407-7820
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Country | US
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Telephone | 843-991-2694
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Fax | 843-405-1316
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Provider Business Mailing Address
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Address Line | 1152 WELLINGTON DR
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City | CHARLESTON
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State | SC
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Zip | 29412-4846
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Country | US
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Telephone | 843-991-2694
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Fax | 843-405-1316
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Authorized Official
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Title or Position | MEMBER
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Name | KAREN A ILGEN
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Credential | OTR/L
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Telephone | 843-991-2694
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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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