Individual
MS. IRAISA M JOSEPHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6849 PEACHTREE DUNWOODY RD NE, SUITE 102 BLG-1, ATLANTA, GA 30328-1610
(866) 587-9922
(678) 587-9993
Mailing address
6849 PEACHTREE DUNWOODY RD NE, SUITE 102 BLG-1, ATLANTA, GA 30328-1610
(866) 587-9922
(678) 587-9993
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
OTA001020
GA
Other
Enumeration date
09/15/2007
Last updated
09/15/2007
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