Individual
MARY KATHERINE STANDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2315 CENTRAL AVE STE C, AUGUSTA, GA 30904-6246
(706) 364-6172
(706) 262-2893
Mailing address
2315 CENTRAL AVE STE C, AUGUSTA, GA 30904-6246
(706) 364-6172
(706) 262-2893
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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