Individual
TAYLER HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
341 WINN WAY, DECATUR, GA 30030-2120
(404) 343-2601
Mailing address
813 PRESTIGE PT, COLLEGE PARK, GA 30349-7995
(404) 729-1832
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007580
GA
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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