Individual
MS. CAROL YVONNE PHILADELPHIA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1154 VILLAGE CRK, JONESBORO, GA 30238-7997
(404) 321-6111
Mailing address
1154 VILLAGE CRK, JONESBORO, GA 30238-7997
(404) 321-6111
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003535
GA
Other
Enumeration date
06/17/2006
Last updated
07/08/2007
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