NPIMap

Alysson Goodwin, Otr/L

Organization Active NPI Pediatric Occupational Therapist · Mount Pleasant, SC

NPI 1669025847 · NPPES record last updated Jul 17, 2019

Key facts

NPI
1669025847
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
Legal business name
ALYSSON GOODWIN, OTR/L
Practice address
1090 Johnnie Dodds Blvd Ste C
Mount Pleasant, SC 29464-6108
Phone
(843) 284-6278
NPI assigned
Jul 17, 2019
Organization subpart
No

Authorized official

Name
Alysson Goodwin, OTR/L
Title
Owner
Phone
(318) 792-1696

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1090 Johnnie Dodds Blvd
Ste C
Mount Pleasant, SC 29464
Phone (843) 284-6278

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP		 225XP0200X Yes

Addresses

Primary practice location

1090 Johnnie Dodds Blvd Ste C
Mount Pleasant, SC 29464-6108

Mailing address

29 Race St
Charleston, SC 29403-4634
Phone (318) 792-1696

Other practice location 1

29 Race St
Charleston, SC 29403-4634
Phone (318) 792-1696

Other identifiers

IdentifierTypeStateIssuer
W53062SC1MedicaidSC

Other providers in Mount Pleasant, SC

All providers in Mount Pleasant, SC · Pediatric Occupational Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.