Provider Demographics
NPI:1174255020
Name:SHOLAR, KENDRA (COTA)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:SHOLAR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 NORTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4293
Mailing Address - Country:US
Mailing Address - Phone:803-324-2202
Mailing Address - Fax:803-620-3087
Practice Address - Street 1:236 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4293
Practice Address - Country:US
Practice Address - Phone:803-324-2202
Practice Address - Fax:803-620-3087
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant