Individual
MRS. CRYSTAL STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
61 HILLCREST DR, JEFFERSONVILLE, GA 31044-3723
(478) 945-0183
Mailing address
61 HILLCREST DR, JEFFERSONVILLE, GA 31044-3723
(478) 945-0183
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001068
GA
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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