Individual
CANDICE SHADEL GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
775 SUNSET DR, ATHENS, GA 30606-2211
(706) 425-1500
Mailing address
748 MOUNTAIN RIDGE WAY, LITHONIA, GA 30058-2923
(678) 230-2579
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001850
GA
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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