Individual
TAMARA TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
290 GA-314 B, FAYETTEVILLE, GA 30214
(404) 994-7727
Mailing address
9657 IVEY RIDGE CIR, JONESBORO, GA 30238-4159
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTA002249
GA
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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