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Individual

MEGAN LOUISE KONRAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
623 LAUREL RIDGE DR., BOX 4192, ELLIJAY, GA 30536
(419) 575-9082
Mailing address
623 LAUREL RIDGE DR # 4192, ELLIJAY, GA 30536-1934
(419) 575-9082

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001916
GA

Other

Enumeration date
01/10/2017
Last updated
01/10/2017
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