Individual
GIDGET BRAGG MAYBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 RENEGAR WAY, SAINT SIMONS ISLAND, GA 31522
(912) 634-4774
Mailing address
111 RENEGAR WAY, SAINT SIMONS ISLAND, GA 31522-8840
(912) 634-4774
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001218
GA
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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