Provider Demographics
NPI:1538538533
Name:WASSERMAN, BETTY (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:
Other - Last Name:COXE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3851 COMMERCIAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-4146
Mailing Address - Country:US
Mailing Address - Phone:843-314-5434
Mailing Address - Fax:888-510-9156
Practice Address - Street 1:3851 COMMERCIAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-4146
Practice Address - Country:US
Practice Address - Phone:843-314-5434
Practice Address - Fax:888-510-9156
Is Sole Proprietor?:No
Enumeration Date:2015-09-20
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4578225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics