Reginald Lasalle Harry, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Ridgeway, SC
NPI 1124684477 · NPPES record last updated May 13, 2019
Key facts
- NPI
- 1124684477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 2412 (SC)
- Practice address
- 117 Bellfield Rd
Ridgeway, SC 29130-8261 - Phone
- (803) 337-2257
- Fax
- (803) 337-2255
- NPI assigned
- May 13, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2412 | SC | Yes |
Addresses
Primary practice location
117 Bellfield Rd
Ridgeway, SC 29130-8261
Mailing address
205 Woodhaven Rd
Columbia, SC 29203-9289
Phone (803) 840-3808
Other practice location 1
2514 Faraway Dr
Columbia, SC 29223-3969
Phone (803) 865-1999
Other practice location 2
880 Carolina Ave
Sumter, SC 29150-2815
Phone (803) 775-5394
Other providers in Ridgeway, SC
- Susan Wright Combs
- Eau Claire Cooperative Health Center, Inc.
- Angela Evans-Morales
- Fairfield Home, LLC
- Darien Harris
- Jessica Marie Hellman
- Keasia James
- Joshua'S Foundation Inc.
- Christy Monica Kennedy
- Nurse Practitioner Solutions, LLC
All providers in Ridgeway, SC · Occupational Therapy Assistant in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.