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NPI Code Detail

MEDICARE: MRS. TARA ANNE CALDER OTR/L

MEDICARE: MRS. TARA ANNE CALDER OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist1841SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528043114
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TARA ANNE CALDER OTR/L
Provider Business Mailing Address
First Line : 212 AMBERJACK CT
Second Line :
City : TAYLORS
State : SC
Zip : 29687-4853
Country : US
Telephone Number : 864-268-8677
Fax Number : 864-268-8677
Provider Business Practice Location Address
First Line : 1132 RUTHERFORD RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29609-3927
Country : US
Telephone Number : 864-250-0005
Fax Number : 864-250-0028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 07/09/2007

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