Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5511 | SC |
NPI | 1326509480 |
---|---|
Provider Name | Caroline Victoria Gallin |
First Address | Columbia, SC 29229-9254 |
Second Address | Columbia, SC 29206-4425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2019 |
Last Update Date | 29/03/2019 |