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Individual

SHIRLEY THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
9800 HUTCHESON FERRY RD, CHATTAHOOCHEE HILLS, GA 30268-2317
(770) 463-5398
Mailing address
9800 HUTCHESON FERRY RD, CHATTAHOOCHEE HILLS, GA 30268-2317

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT001002
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000811258B
GA
Enumeration date
07/22/2014
Last updated
07/22/2014
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