Individual
COURTNEY DEGRAFFENREID-ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2848 LENOX RD NE, ATLANTA, GA 30324-6004
(678) 249-7120
Mailing address
PO BOX 500, DALLAS, GA 30132-0009
(678) 249-7120
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006822
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT006822
LICENSE NUMBER
GA
Enumeration date
03/05/2019
Last updated
03/05/2019
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