Individual
ASHLEY NICOLE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
90 E STEPHENS ST, CAMILLA, GA 31730-1836
(229) 336-4619
Mailing address
90 E STEPHENS ST, CAMILLA, GA 31730-1836
(229) 336-4619
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006830
GA
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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