Individual
TAYLOR LEWIS REVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1357 ALDERMAN RD, BROOKLET, GA 30415-8234
(912) 536-6838
Mailing address
1357 ALDERMAN RD, BROOKLET, GA 30415-8234
(912) 536-6838
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008909
GA
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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