Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT008303 | GA |
NPI | 1063170348 |
---|---|
Provider Name | Hannah Ekhlas |
First Address | Cumming, GA 30041-5542 |
Second Address | Cumming, GA 30041-5542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2021 |
Last Update Date | 03/12/2021 |