Individual
AMANDA GRANBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 JOHNSON FERRY RD, MARIETTA, GA 30062-6492
(770) 977-9457
Mailing address
4038 CHAPEL GROVE DR, MARIETTA, GA 30062-1069
(678) 313-6218
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006257
GA
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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