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Individual

MICHELLE RAPHAEL BLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2061 PEACHTREE RD NW #500, ATLANTA, GA 30309, ATLANTA, GA 30309-1446
(404) 352-3522
Mailing address
2061 PEACHTREE RD NW, ATLANTA, GA 30309

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119009488
VA
225X00000X
Occupational Therapist
OT007601
GA
225XH1200X
Hand Occupational Therapist
Primary
OT007601
GA

Other

Enumeration date
01/16/2020
Last updated
09/18/2024
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