Individual
KRISTEN DAWN GRADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(229) 942-8070
Mailing address
255 MEADOWS DR, SENOIA, GA 30276-3145
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
006152
GA
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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