Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 1098 | SC |
NPI | 1053891226 |
---|---|
Provider Name | Mrs. Nancy Waters Poston |
First Address | Florence, SC 29506-5213 |
Second Address | Florence, SC 29506-2538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2018 |
Last Update Date | 17/08/2018 |