Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5864 | SC |
NPI | 1376156521 |
---|---|
Provider Name | Hailey Wolfe |
First Address | Greenville, SC 29601-3369 |
Second Address | Greenville, SC 29601-3369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2020 |
Last Update Date | 27/08/2020 |