Individual
MS. KATHLEEN SMALLIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
2206 GLENDALE RD, AUGUSTA, GA 30904-3434
(646) 385-1534
Mailing address
2206 GLENDALE RD, AUGUSTA, GA 30904-3434
(646) 385-1534
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
015850
NY
225X00000X
Occupational Therapist
Primary
OT005985
GA
Other
Enumeration date
09/16/2009
Last updated
08/06/2014
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