Individual
KYLIE ELIZABETH WOMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
947 PEEL CASTLE LN, AUSTELL, GA 30106-1467
(803) 609-1395
Mailing address
947 PEEL CASTLE LN, AUSTELL, GA 30106-1467
(803) 609-1395
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006762
GA
Other
Enumeration date
07/16/2017
Last updated
07/16/2017
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