Individual
MRS. VICKI MAXWELL ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
812 S PARK ST, CARROLLTON, GA 30117-4412
(770) 834-7436
(770) 830-5954
Mailing address
812 S PARK ST, CARROLLTON, GA 30117-4412
(770) 834-7436
(770) 830-5954
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000163
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00564539B
—
GA
Enumeration date
04/14/2006
Last updated
02/28/2012
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