Individual
KATIE TESSA BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
134 S 6TH ST, COCHRAN, GA 31014-6626
(229) 318-9989
Mailing address
54 LENNIE LN, EASTMAN, GA 31023-6465
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001856
GA
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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