Individual
MRS. MARRIANNE MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
349 HICKORY GROVE RD, LEESBURG, GA 31763-5310
(229) 888-6699
Mailing address
349 HICKORY GROVE RD, LEESBURG, GA 31763-5310
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT000200
GA
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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