Individual
MRS. RETHA MAE CARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH OTR/L CHT
Contact information
Practice address
920 RIVER CENTRE PL, SUITE 200, LAWRENCEVILLE, GA 30043-7320
(770) 682-6225
(770) 682-6275
Mailing address
PO BOX 1230, LAWRENCEVILLE, GA 30046-1230
(770) 682-6225
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT 003690
GA
225XH1200X
Hand Occupational Therapist
Primary
OT003690
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9611000449
HAND THERAPY CERTIFICATE
GA
Enumeration date
10/05/2007
Last updated
01/30/2009
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