Individual
BREENA KATHLEEN TICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS - OTR/L
Contact information
Practice address
5000 GATEWAY BLVD, GROVETOWN, GA 30813-3353
(762) 622-4000
Mailing address
5000 GATEWAY BLVD, GROVETOWN, GA 30813-3353
(762) 622-4000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004753
GA
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/29/2008
Last updated
03/24/2026
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