Provider Demographics
NPI:1215339429
Name:MCALISTER, PAULA M
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:MCALISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:M
Other - Last Name:MCALISTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTA
Mailing Address - Street 1:980 W BAZEN RD
Mailing Address - Street 2:
Mailing Address - City:PAMPLICO
Mailing Address - State:SC
Mailing Address - Zip Code:29583-5253
Mailing Address - Country:US
Mailing Address - Phone:843-319-5048
Mailing Address - Fax:843-669-7144
Practice Address - Street 1:507 W CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4449
Practice Address - Country:US
Practice Address - Phone:843-669-1188
Practice Address - Fax:843-669-7144
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2191224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant