Individual
SARA SHACKLEFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2280 HIGHWAY 29 N, NEWNAN, GA 30265-1031
(770) 683-6833
Mailing address
470 BLANDENBURG RD, CARROLLTON, GA 30116-8971
(678) 634-2887
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001878
GA
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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