IndividualActive
Angel Gibson, COTA/L
NPI 1093409674 · Occupational Therapy Assistant · Charleston, SC
Provider details
- NPI number
- 1093409674
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- Yes
- License
- 5174 (SC)
Mailing address
1114 Flyway Rd
Summerville, SC 29483-8021
Registry dates
- Enumerated
- 2023-06-06
- Last updated
- 2023-10-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.