Individual
MELISSA HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2095 HIGHWAY 211 NW, BRASELTON, GA 30517-3402
(770) 207-6390
Mailing address
1071 THOMAS AVE, WATKINSVILLE, GA 30677-6073
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT007648
PROVIDER LICENSE
GA
Enumeration date
02/13/2020
Last updated
12/07/2022
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