Provider Demographics
NPI:1871237214
Name:MCCARLEY, TRINITY STEPHANIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:STEPHANIE
Last Name:MCCARLEY
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 1:310 BARNWELL AVE NE
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-4406
Mailing Address - Country:US
Mailing Address - Phone:803-641-4144
Mailing Address - Fax:
Practice Address - Street 1:115 GREENVILLE ST SW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3810
Practice Address - Country:US
Practice Address - Phone:803-270-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6239225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist