Individual
MRS. JOAN EBERSOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
300 EAGLES POINTE PKWY, STOCKBRIDGE, GA 30281-6384
(678) 432-4755
Mailing address
261 MONTROSE DR, MCDONOUGH, GA 30253-4243
(678) 432-4755
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000520
GA
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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