Provider Demographics
NPI:1164785184
Name:PRINGLE, KATERRI (OWNER)
Entity Type:Individual
Prefix:
First Name:KATERRI
Middle Name:
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 HARD SCRABBLE RD STE 312
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8584
Mailing Address - Country:US
Mailing Address - Phone:803-708-1221
Mailing Address - Fax:803-339-4037
Practice Address - Street 1:1053A SPARKLEBERRY LANE EXT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7066
Practice Address - Country:US
Practice Address - Phone:803-708-1221
Practice Address - Fax:803-339-4037
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty