Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT007413 | GA |
NPI | 1023656758 |
---|---|
Provider Name | Brittany Dolores Norman |
First Address | Atlanta, GA 30309-3884 |
Second Address | Roswell, GA 30075-8009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2019 |
Last Update Date | 12/12/2019 |