Individual
MRS. JILLANN MARIE DRAGOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
603 PARKVIEW DR, CANTON, GA 30114-5847
(678) 880-7580
Mailing address
603 PARKVIEW DR, CANTON, GA 30114-5847
(678) 880-7580
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001092
GA
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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