Provider Demographics
NPI:1063805885
Name:THOMAS, JAN CATHERINE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JAN
Middle Name:CATHERINE
Last Name:THOMAS
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 1:102 CHERYL LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7921
Mailing Address - Country:US
Mailing Address - Phone:718-669-0298
Mailing Address - Fax:
Practice Address - Street 1:9565 HIGHWAY 78 BLDG 700
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-4116
Practice Address - Country:US
Practice Address - Phone:843-569-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7721225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics