Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 212096 | GA |
NPI | 1023453685 |
---|---|
Provider Name | Brandy Biggs |
First Address | Cumming, GA 30028-3359 |
Second Address | Colorado City, TX 79512-3916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2013 |
Last Update Date | 08/05/2013 |