Provider Demographics
NPI:1568541050
Name:DUNCAN, MARY BETH (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:BETH
Last Name:DUNCAN
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 1:1807 EAST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640
Mailing Address - Country:US
Mailing Address - Phone:662-415-5684
Mailing Address - Fax:864-306-7977
Practice Address - Street 1:1807 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640
Practice Address - Country:US
Practice Address - Phone:662-415-5684
Practice Address - Fax:864-306-7977
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3209225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics