Individual
MRS. DISHA SAI MUDULODU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3985 STEVE REYNOLDS BLVD BLDG G, NORCROSS, GA 30093-3001
(770) 622-2532
(770) 622-2534
Mailing address
5817 STOW DR, TUCKER, GA 30084-8478
(404) 966-4476
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005131
GA
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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