Individual
MRS. ADDISON PONDER FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD,OTR/L
Contact information
Practice address
428 S ENOTA DR NE, GAINESVILLE, GA 30501-2548
(678) 616-3099
Mailing address
428 S ENOTA DR NE, GAINESVILLE, GA 30501-2548
(229) 400-8180
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008256
GA
Other
Enumeration date
10/28/2021
Last updated
04/04/2023
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