Individual
MS. MARILYN JENNIFER SMITH-HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA, CAPS
Contact information
Practice address
3617 EBENEZER RD, MARIETTA, GA 30066-2819
(757) 589-0864
(770) 805-0556
Mailing address
3617 EBENEZER RD, MARIETTA, GA 30066-2819
(757) 589-0864
(770) 805-0556
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213831
TX
224ZE0001X
Environmental Modification Occupational Therapy Assistant
OTA000977
GA
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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