Individual
KATHYRN STAPLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1014 FORSYTH ST, MACON, GA 31201-2051
(478) 633-8100
(478) 633-6268
Mailing address
1014 FORSYTH ST, MACON, GA 31201-2051
(478) 633-8100
(478) 633-6268
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT005783
GA
Other
Enumeration date
12/10/2013
Last updated
08/18/2020
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