Provider Demographics
NPI:1013349760
Name:WITZEL, ISABELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:WITZEL
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 1:2233 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-6941
Mailing Address - Country:US
Mailing Address - Phone:803-548-2527
Mailing Address - Fax:
Practice Address - Street 1:2233 DEERFIELD DR
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-6941
Practice Address - Country:US
Practice Address - Phone:803-548-2527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2699225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics