Provider Demographics
NPI:1528469723
Name:GRABER, LINDA ANN (MSR, OTR/L)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:GRABER
Suffix:
Gender:F
Credentials:MSR, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 TRAPIER DR
Mailing Address - Street 2:CHARLESTON
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9144
Mailing Address - Country:US
Mailing Address - Phone:843-795-4213
Mailing Address - Fax:
Practice Address - Street 1:1316 RUTLEDGE AVE STE 104
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-3050
Practice Address - Country:US
Practice Address - Phone:843-790-5077
Practice Address - Fax:843-998-7645
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2447225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist