Individual
TATIANA OTALORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6020 DAWSON BLVD, NORCROSS, GA 30093-1229
(770) 662-0249
Mailing address
576 KILLIAN HILL RD SW, LILBURN, GA 30047-4064
(678) 914-3315
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
089613-1
NY
104100000X
Social Worker
Primary
MSW006471
GA
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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