Provider Demographics
NPI:1780923888
Name:SHUFORD, ANNA M (MSOT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:SHUFORD
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 HAWKSBILL CT
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5120
Mailing Address - Country:US
Mailing Address - Phone:843-901-8454
Mailing Address - Fax:
Practice Address - Street 1:1127 QUEENSBOROUGH BLVD
Practice Address - Street 2:STE 104
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5431
Practice Address - Country:US
Practice Address - Phone:843-216-0290
Practice Address - Fax:843-216-2445
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4067225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics