Individual
DR. MIRAGE MARIAH SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
3160 MAIN ST STE 103, DULUTH, GA 30096-3461
(678) 404-7744
Mailing address
3005 LAKESIDE CIR, COVINGTON, GA 30016-8852
(470) 435-5629
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT009323
GA
Other
Enumeration date
09/23/2024
Last updated
10/01/2024
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