Individual
MS. EDNA RAYCINE HAISLIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1120 15TH ST, BIW-6045, AUGUSTA, GA 30912-0004
(706) 721-2484
Mailing address
PO BOX 845, 115 HOWELL ST, GROVETOWN, GA 30813-0845
(706) 825-1116
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT000760
GA
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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