Individual
MRS. LAURIE BLANCHARD VERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS, OTR/L
Contact information
Practice address
812 CAMELLIA RD, AUGUSTA, GA 30909-2734
(706) 495-6548
Mailing address
812 CAMELLIA RD, AUGUSTA, GA 30909-2734
(706) 495-6548
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004981
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258614
NBCOT
—
05
—
304613285ABC
—
GA
Enumeration date
10/07/2009
Last updated
03/23/2011
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