Individual
KRISTIN EBERSOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
208 MAXWELL ST, DECATUR, GA 30030-4209
(404) 931-1615
Mailing address
208 MAXWELL ST, DECATUR, GA 30030-4209
(404) 931-1615
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2532
GA
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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