Individual
ELIZABETH POULSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5150 STILESBORO RD NW, SUITE 430, KENNESAW, GA 30152-7744
(770) 218-2300
Mailing address
5150 STILESBORO RD NW, SUITE 430, KENNESAW, GA 30152-7744
(770) 218-2300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT000475
GA
Other
Enumeration date
09/02/2013
Last updated
09/02/2013
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