Individual
NIVEDITA NAYAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3888 LAVISTA RD, TUCKER, GA 30084-5142
(770) 938-5740
Mailing address
3888 LAVISTA RD, TUCKER, GA 30084-5142
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT001416
GA
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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