Provider Demographics
NPI:1780046383
Name:GILBERT, COURTNEY SARA (MSOTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SARA
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MSOTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2439 WILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3904
Mailing Address - Country:US
Mailing Address - Phone:843-777-2043
Mailing Address - Fax:
Practice Address - Street 1:77 BATES ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7637
Practice Address - Country:US
Practice Address - Phone:207-795-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005673225X00000X
SCOT. 4701 OT225X00000X
MEOT2715225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist