Provider Demographics
NPI:1255806311
Name:MARAGOS, MILENA (OTR/L)
Entity type:Individual
Prefix:
First Name:MILENA
Middle Name:
Last Name:MARAGOS
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 1:826 OLD AIRPORT RD APT 931
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-0905
Mailing Address - Country:US
Mailing Address - Phone:304-794-9720
Mailing Address - Fax:
Practice Address - Street 1:716 E CEDAR ROCK ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2324
Practice Address - Country:US
Practice Address - Phone:864-878-4739
Practice Address - Fax:864-878-1657
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5078225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist