Provider Demographics
NPI:1497713721
Name:STRESEMANN, NORA G (OTR L)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:G
Last Name:STRESEMANN
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:MS
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:STRESEMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTRL
Mailing Address - Street 1:570 LONG POINT RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7930
Mailing Address - Country:US
Mailing Address - Phone:843-884-4783
Mailing Address - Fax:843-884-1979
Practice Address - Street 1:570 LONG POINT RD
Practice Address - Street 2:SUITE 270
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7930
Practice Address - Country:US
Practice Address - Phone:843-884-4783
Practice Address - Fax:843-884-1979
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2013-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC201225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1080Medicaid
SCTH1080Medicaid