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Individual

KELSEY TAYLOR LISICIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
500 LANIER AVE W STE 603, FAYETTEVILLE, GA 30214-7644
(404) 861-7588
Mailing address
749 MCLAURIN ST, GRIFFIN, GA 30224-5023
(404) 861-7588

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006851
GA

Other

Enumeration date
03/27/2020
Last updated
03/27/2020
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