Individual
KERONE MAXINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3985 STEVE REYNOLDS BLVD BLDG G, NORCROSS, GA 30093-3001
(770) 622-2532
(770) 622-2534
Mailing address
3985 STEVE REYNOLDS BLVD BLDG G, NORCROSS, GA 30093-3001
(770) 622-2532
(770) 622-2532
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004775
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00006570
—
NY
Enumeration date
06/30/2006
Last updated
09/01/2017
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