Individual
ELLENORA E AVILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1500 OGLETHORPE AVE, ATHENS, GA 30606-2179
(706) 389-2273
Mailing address
PO BOX 6588, ST MARYS HOME HEALTH CARE, ATHENS, GA 30604-9828
(706) 389-2273
(706) 208-8883
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
001956
GA
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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