Individual
JACQUELYN LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1113 OAK HOLLOW CT, HAMPTON, GA 30228-5571
(770) 873-9930
Mailing address
1113 OAK HOLLOW CT, HAMPTON, GA 30228-5571
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000486
GA
Other
Enumeration date
03/03/2014
Last updated
03/03/2014
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