Individual
MRS. MIKA LEY CYRUS PACIFICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21681
CA
Other
Enumeration date
10/13/2020
Last updated
03/11/2024
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