Individual
MRS. DETISHIA DENISE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6849 PEACHTREE DUNWOODY RD NE, ATLANTA, GA 30328-1610
(678) 587-9922
Mailing address
1436 WILSON MANOR CIR, LAWRENCEVILLE, GA 30045-3752
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000847
GA
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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