Provider Demographics
NPI:1356115414
Name:MCELVEEN, TATYANA (OTR)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:MCELVEEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:TATYANA
Other - Middle Name:
Other - Last Name:OIKHBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:8626 DORCHESTER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7328
Mailing Address - Country:US
Mailing Address - Phone:843-964-4996
Mailing Address - Fax:888-856-3189
Practice Address - Street 1:8626 DORCHESTER RD STE 103
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7328
Practice Address - Country:US
Practice Address - Phone:843-964-4996
Practice Address - Fax:888-856-3189
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4005225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist