Provider Demographics
NPI:1992277966
Name:PATTERSON, RAYMONICA (COTA/L)
Entity type:Individual
Prefix:MS
First Name:RAYMONICA
Middle Name:
Last Name:PATTERSON
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 1:213 RANGE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29626-6045
Mailing Address - Country:US
Mailing Address - Phone:864-202-1015
Mailing Address - Fax:
Practice Address - Street 1:213 RANGE VIEW RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29626-6045
Practice Address - Country:US
Practice Address - Phone:864-202-1015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3197225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics