Individual
AUTUMN BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
935 WAYNE RD, SAVANNAH, TN 38372-1904
(731) 727-8010
Mailing address
65 SHANNON LN, COUNCE, TN 38326-2044
(731) 438-1140
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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