Individual
SUMMER MARIAH KING DEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2415 PARKWOOD DR, BRUNSWICK, GA 31520-4722
(912) 466-2610
Mailing address
503 FOX RUN CIRCLE, BRUNSWICK, GA 31525
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003475
GA
225X00000X
Occupational Therapist
OT10308
FL
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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