Individual
RENEE MARIE MIRANDA VALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 TANNERS CT, COVINGTON, GA 30016-2302
(678) 687-3311
Mailing address
85 TANNERS CT, COVINGTON, GA 30016-2302
(678) 687-3311
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004527
GA
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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