Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 3816 | SC |
NPI | 1043559776 |
---|---|
Provider Name | Mrs. Stefani S Ankeny |
First Address | Summerville, SC 29485 |
Second Address | North Charleston, SC 29406-3439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2013 |
Last Update Date | 31/01/2013 |