Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 783A | CO |
NPI | 1093886103 |
---|---|
Provider Name | Ms. Charlene Renae Bone |
First Address | Summerville, SC 29485-8908 |
Second Address | North Charleston, SC 29406-9171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2006 |
Last Update Date | 08/07/2007 |