Individual
LACEY PATRICE HITCHINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
307 E 3RD AVE, CORDELE, GA 31015-3208
(229) 271-4612
Mailing address
307 E 3RD AVE, CORDELE, GA 31015-3208
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT005321
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049979274
GEORGIA DRIVER'S LICENSE
GA
Enumeration date
02/20/2012
Last updated
02/20/2012
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