Individual
THERESA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
311 COOPER RD, LOGANVILLE, GA 30052-4976
(678) 205-5437
(678) 377-7950
Mailing address
1024 ORCHARD CIR, MONROE, GA 30656-7938
(678) 205-5437
(678) 377-7950
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004492
GA
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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