Individual
DANYELLE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3609 DRUID OAKS DR, VALDOSTA, GA 31605-6543
(229) 415-9555
Mailing address
3609 DRUID OAKS DR, VALDOSTA, GA 31605-6543
(229) 415-9555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002831
GA
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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