Individual
MELISSA DOLORES MCDIVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
128 FRANCES MEEKS WAY, RICHMOND HILL, GA 31324-3983
(912) 727-2321
Mailing address
977 BIRCHFIELD DR, HINESVILLE, GA 31313-6478
(321) 480-1274
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001464
GA
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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