Individual
SHARDAE PORTEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
966A KILLIAN HILL RD SW, LILBURN, GA 30047-3102
(770) 923-4815
Mailing address
6250 RIVERVIEW RD SE APT 2116, SMYRNA, GA 30126-2979
(803) 372-7151
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT006777
GA
Other
Enumeration date
03/09/2017
Last updated
11/15/2021
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