Individual
MARETTA GEORGETTA MINCEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2735 LOST LAKES DRIVE, POWDER SPRINGS, GA 30127
(770) 896-6518
(678) 567-1926
Mailing address
PO BOX 385, POWDER SPRINGS, GA 30127-0385
(770) 896-6518
(678) 567-1926
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003165
GA
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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