Individual
ERIKA LYNN MIDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA, CLT
Contact information
Practice address
1170 SHAWNEE ST, SAVANNAH, GA 31419-1618
(912) 920-0214
Mailing address
423 SCUFFLETOWN RD, GUYTON, GA 31312-6540
(304) 904-3464
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001823
GA
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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