Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 2841 | SC |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2841 | SC |
N | 225XP0200X | Occupational Therapist - Pediatrics | 2841 | SC |
NPI | 1821268087 |
---|---|
Provider Name | Dina J Caldwell |
First Address | Lake City, SC 29560-2462 |
Second Address | Lake City, SC 29560-2462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2008 |
Last Update Date | 04/03/2008 |