Individual
LAURA SUPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
536 GRAND SLAM DR, SUITE D, EVANS, GA 30809-8044
(706) 854-8434
(706) 854-8435
Mailing address
536 GRAND SLAM DR, SUITE D, EVANS, GA 30809-8044
(706) 854-8434
(706) 854-8435
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005650
GA
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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