Individual
MRS. SOPHIA ANNMARIE CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6600 PEACHTREE DUNWOODY RD BLDG 40030328, ATLANTA, GA 30328-6773
(678) 587-9922
Mailing address
2442 BARN HORSE CT, DACULA, GA 30019-7505
(914) 356-4756
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002315
GA
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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