Individual
MRS. MARY ELIZABETH MILLER WILLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-2865
(706) 721-2273
Mailing address
3485 GREENWAY DR, EVANS, GA 30809-4276
(912) 657-0140
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005159
GA
Other
Enumeration date
06/07/2011
Last updated
03/04/2019
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