Individual
MS. ELISE LEONA LIVESEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
5408 PARK CIR, STONE MOUNTAIN, GA 30083-2260
(147) 023-4755
Mailing address
695 OXFORD HALL DR, LAWRENCEVILLE, GA 30044-6004
(678) 983-9159
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006923
GA
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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