Individual
LOUISA L AFFLECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
59 EXECUTIVE DRIVE SOUTH, SUITE1100, ATLANTA, GA 30329-2208
(404) 778-6330
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-6560
(219) 365-6561
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-GA130
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT-GA130
STATE LISC NUMBER
GA
Enumeration date
11/27/2006
Last updated
12/06/2011
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