| NPI | 1598960007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN L MITCHELL Owner 229-247-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: GA OT003572 GA) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-08-22 |