Individual
JENNESSEE ELIZABETH GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
469 BRYSON CIR, HAHIRA, GA 31632-1286
(229) 300-0776
Mailing address
469 BRYSON CIR, HAHIRA, GA 31632-1286
(229) 300-0776
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002865
GA
224Z00000X
Occupational Therapy Assistant
OTA18830
FL
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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