Provider Demographics
NPI:1235285958
Name:GUADARRAMA, ANNE E (OT)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:E
Last Name:GUADARRAMA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:E
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:376 STRASBURG DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4562
Mailing Address - Country:US
Mailing Address - Phone:864-430-9876
Mailing Address - Fax:
Practice Address - Street 1:420 THE PKWY
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-5204
Practice Address - Country:US
Practice Address - Phone:864-244-3474
Practice Address - Fax:864-244-3475
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16854225XP0200X
SC3039225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1608Medicaid