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NPI 1841925286

NPI 1841925286 : HARPER NICOLE WINICOV DOT, OTR/L : CHARLESTON, SC

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General NPI Number Information
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    NPI Number           |    1841925286
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    Entity Type          |    Individual 
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    Provider Name        |    HARPER NICOLE WINICOV DOT, OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/20/2022
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    Last Update Date     |    07/20/2022
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Provider Practice Location Address
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    Address Line         |    672 MARINA DR STE 104 
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    City                 |    CHARLESTON
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    State                |    SC
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    Zip                  |    29492-9084
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    Country              |    US
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    Telephone            |    336-528-0518
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1555 BLAZE LN 
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    City                 |    CHARLESTON
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    State                |    SC
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    Zip                  |    29412-8653
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    Country              |    US
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    Telephone            |    336-528-0518
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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        |    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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