Individual
KYANNA DENEE GROOMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3007 PANOLA RD STE C, LITHONIA, GA 30038
(770) 987-1122
(770) 987-1149
Mailing address
7 CARNEGIE PLZ, CHERRY HILL, NJ 08003-1000
(877) 407-3422
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006502
GA
Other
Enumeration date
08/04/2016
Last updated
01/20/2021
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