| NPI | 1003148289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EULANDA LARA WALLER Owner 478-318-2313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT003394) |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification (Licence: GA OT003394) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |