Individual
KRISTEN LARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 JENNINGS MILL RD, WATKINSVILLE, GA 30677-7238
(706) 552-1920
Mailing address
921 DOWNING DR, BETHLEHEM, GA 30620-2053
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT006878
GA
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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