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General NPI Number Information
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NPI Number | 1922315027
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Entity Type | Organization
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Legal Business Name | CAROLINA CHILDREN'S THERAPY LLC
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 2060 NORTHBROOK BLVD, SUITE 103
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City | N CHARLESTON
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State | SC
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Zip | 29406-9811
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Country | US
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Telephone | 843-572-2450
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Fax | 843-572-2451
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Provider Business Mailing Address
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Address Line | 2060 NORTHBROOK BLVD, SUITE 103 CAROLINA CHILDREN'S THERAPY LLC
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City | N. CHARLESTON
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State | SC
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Zip | 29406-9811
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Country | US
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Telephone | 843-572-2450
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Fax | 843-572-2451
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. NESSIE P SCHROM
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Credential | OTR/L, BCP
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Telephone | 843-572-2450
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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 | 1334
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License Number State | SC
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