Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT005338 | GA |
NPI | 1073712394 |
---|---|
Provider Name | Michelle Duplechin Mccrory |
First Address | White, GA 30184-3476 |
Second Address | White, GA 30184-3476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 14/11/2014 |