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Individual

MIRACLE WATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1865 BOLD SPRINGS RD NW, MONROE, GA 30656-4605
(770) 267-8677
Mailing address
2671 WYNTER SNOW RUN, BETHLEHEM, GA 30620-4696
(770) 962-4760

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000187
GA

Other

Enumeration date
04/28/2011
Last updated
04/28/2011
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