Individual
MS. CRYSTAL LEA SWAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
102 LAVENDER LN, LEESBURG, GA 31763-4564
(229) 888-7688
Mailing address
102 LAVENDER LN, LEESBURG, GA 31763-4564
(229) 888-7688
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
001009
GA
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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