Individual
SANDRA DIANE MCSPADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
4405 EVANS TO LOCKS RD, SUITE C, EVANS, GA 30809-3603
(706) 854-1598
(706) 854-8136
Mailing address
4117 FOX BRUSH DR, EVANS, GA 30809-4857
(706) 650-9024
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1795
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00979679A
—
GA
Enumeration date
12/19/2006
Last updated
07/09/2007
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