Individual
SITA KAMARIA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3012 WOODLANDS DR SE, SMYRNA, GA 30080-8421
(706) 877-6073
Mailing address
3012 WOODLANDS DR SE, SMYRNA, GA 30080-8421
(706) 877-6073
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001241
GA
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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