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Individual

CHANDLER HENSHAW EDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
402 GENERAL COURTNEY HODGES BOULEVARD, 301, KATHLEEN, GA 31047
(478) 213-2927
Mailing address
402 GENERAL COURTNEY HODGES BOULEVARD, 301, KATHLEEN, GA 31047
(478) 213-2927

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002569
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
87-405-3673
BCBS, UNITED HEALTHCARE, AETNA, TRICARE, CIGNA, HUMANA, SELF-PAY
GA
Enumeration date
12/22/2021
Last updated
12/22/2021
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