Individual
MRS. REGINA MICHELLE DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1067 BATTLEFIELD PKWY, FORT OGLETHORPE, GA 30742-3947
(706) 861-5154
(706) 858-8542
Mailing address
1011 CARGAL ROAD, DALTON, GA 30721
(706) 278-3848
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000856
GA
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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