Provider Demographics
NPI:1740529924
Name:MACNAUGHTON, ELIZABETH WHITTINGTON (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:WHITTINGTON
Last Name:MACNAUGHTON
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 1:12 SWAINSON CT
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7808
Mailing Address - Country:US
Mailing Address - Phone:803-553-3707
Mailing Address - Fax:
Practice Address - Street 1:715 9TH ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7169
Practice Address - Country:US
Practice Address - Phone:803-600-8749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2863225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist