| NPI | 1063960425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANEKA A LAVENDER Cota/L 678-458-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: AZ 5558) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |