Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1245836220 |
---|---|
Provider Name | Mrs. Kaitlyn B. Ogle |
First Address | Camden, SC 29020-3712 |
Second Address | Camden, SC 29020-3712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2020 |
Last Update Date | 11/10/2021 |