Individual
ANNA PORTER GOBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOT/RL
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2208
(404) 686-1391
Mailing address
14 ANASTASIA DR SE, MABLETON, GA 30126-1461
(702) 481-0072
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
09-0165
NV
225X00000X
Occupational Therapist
Primary
OT005543
GA
Other
Enumeration date
01/01/2013
Last updated
07/29/2013
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