LATASHA NICOLE MALLARD

CARROLLTON, GA
NPI1053183723
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: GA  OTA002989)
Enumeration Date2023-10-26
Last Update Date2023-10-26
Business Address
LATASHA NICOLE MALLARD
150 COTTAGE LN
CARROLLTON, GA 30117-6200
Phone number: 770-830-8857
Mailing Address
LATASHA NICOLE MALLARD
150 COTTAGE LN
CARROLLTON, GA 30117-6200
Phone number: 770-830-8857
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