| NPI | 1811052178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA RUSSELL President Manager 770-996-7213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT002185) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |