Provider Demographics
NPI:1326517269
Name:FOTI, TAYLOR WILLIAMS (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:WILLIAMS
Last Name:FOTI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:TAYLOR
Other - Middle Name:CHRISTIAN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:PO BOX 1523
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-1523
Mailing Address - Country:US
Mailing Address - Phone:843-455-7505
Mailing Address - Fax:
Practice Address - Street 1:4761 HIGHWAY 501 STE 1
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-9457
Practice Address - Country:US
Practice Address - Phone:843-455-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007210225XP0200X
SC5865225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics