Individual
MRS. CAROLINE ELIZABETH HOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT R/L
Contact information
Practice address
4962 FALCON WOOD CT, MARIETTA, GA 30066-1283
(404) 617-0428
Mailing address
4962 FALCON WOOD CT, MARIETTA, GA 30066-1283
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008120
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891109831
—
GA
Enumeration date
08/03/2021
Last updated
08/09/2021
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