Individual
GEORGIE PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2331 HANSEN CT, TALLAHASSEE, FL 32301-4859
(850) 320-6555
Mailing address
2331 HANSEN CT, TALLAHASSEE, FL 32301-4859
(850) 320-6555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA002870
GA
224Z00000X
Occupational Therapy Assistant
Primary
OTA14452
FL
Other
Enumeration date
08/30/2022
Last updated
09/24/2023
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