Individual
EBONY BURROUGHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4319 S LEE ST STE 300, BUFORD, GA 30518-5752
(678) 288-9770
Mailing address
2705 MALL OF GEORGIA BLVD APT 904, BUFORD, GA 30519-8734
(205) 789-5310
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008574
GA
Other
Enumeration date
05/03/2023
Last updated
07/17/2023
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