Provider Demographics
NPI:1972886919
Name:PUTNAM, RHONDA LYNN (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LYNN
Last Name:PUTNAM
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 PATRIOT LN
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-5282
Mailing Address - Country:US
Mailing Address - Phone:570-250-0463
Mailing Address - Fax:
Practice Address - Street 1:601 SULPHUR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-1621
Practice Address - Country:US
Practice Address - Phone:864-246-2721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2963224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant