Individual
MS. COURTNEY SHALLYA DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1479 GROVE PARK DR, COLUMBUS, GA 31904
(706) 530-9409
Mailing address
797 DOUGLAS DR, ELLERSLIE, GA 31807-5655
(706) 987-7018
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002437
GA
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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