Cynthia Lynn Clubb-Charles, OTR/L
Occupational Therapist, Pediatrics in Columbia, SC. Individual provider (NPI-1).
NPI number1891122016
StatusActive
Last updated in NPPESOct 2, 2013
Details
- NPI
- 1891122016
- Entity type
- Individual (NPI-1)
- Name
- Ms. Cynthia Lynn Clubb-Charles
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 2, 2013
- Last updated
- Oct 2, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XP0200X | Occupational Therapist, Pediatrics | 424 | SC | Yes |
Practice location
430 Wagner TrlColumbia, SC 29229-7036
Phone 803-479-7904
Mailing address
430 Wagner TrlColumbia, SC 29229-7036
Phone 803-479-7904
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