Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT003609 | GA |
NPI | 1255778775 |
---|---|
Provider Name | Mrs. Courtney Ann Muller |
First Address | Decatur, GA 30030-3103 |
Second Address | Hapeville, GA 30354-1706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 23/05/2013 |