Individual
AVA TRUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5723 GA HIGHWAY 21 S, RINCON, GA 31326-5554
(912) 667-6468
(912) 324-4241
Mailing address
PO BOX 1220, RINCON, GA 31326-1220
(912) 667-6468
(912) 324-4241
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008305
GA
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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