| NPI | 1871885137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY TYLER BRABHAM Manager/Owner 706-339-1635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA 3450) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 2579) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-07-04 |