Provider Demographics
NPI:1235535543
Name:WATKINS, CAMILLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 AYERS CIR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-3306
Mailing Address - Country:US
Mailing Address - Phone:843-769-0663
Mailing Address - Fax:843-769-0665
Practice Address - Street 1:2070 NORTHBROOK BLVD
Practice Address - Street 2:SUITE B-4
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9252
Practice Address - Country:US
Practice Address - Phone:843-569-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist