Provider Demographics
NPI:1811733199
Name:MAHONEY, MARGARET (OTD R/L)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:OTD R/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HARBOR POINTE DR APT 4
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5635
Mailing Address - Country:US
Mailing Address - Phone:803-629-7276
Mailing Address - Fax:
Practice Address - Street 1:4105 FABER PI DR
Practice Address - Street 2:SUITE 420
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405
Practice Address - Country:US
Practice Address - Phone:843-894-7374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7234225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist