Individual
CALLIE DIANE LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
14557 US-19, SUITE C, GRIFFIN, GA 30224
(770) 468-6941
Mailing address
1050 MCDONOUGH RD, JACKSON, GA 30233-1524
(770) 775-7861
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT009340
GA
225XP0200X
Pediatric Occupational Therapist
OT009340
GA
Other
Enumeration date
11/27/2024
Last updated
03/19/2025
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