Provider Demographics
NPI:1508490103
Name:ATKINSON, ALICE LOUISE MCDONALD (OT/R)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:LOUISE MCDONALD
Last Name:ATKINSON
Suffix:
Gender:
Credentials:OT/R
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:LOUISE SARA
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1185 WILSON HALL RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1842
Mailing Address - Country:US
Mailing Address - Phone:803-469-3213
Mailing Address - Fax:
Practice Address - Street 1:1185 WILSON HALL RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1842
Practice Address - Country:US
Practice Address - Phone:803-469-3213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5775225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist