NPI 1396455754

Holly Georgiana Moore, COTAL

Practitioner Occupational Therapy Assistant Tifton, GA

Practice location

Address: 1401 Tift Ave N STE B, Tifton, GA 31794-3577
Phone: (229) 396-5644
Fax: (855) 565-1769
Mailing address: 69 Atwater Rd, Tifton, GA 31794-8513

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence OTA002554 (GA)

Other Occupational Therapy Assistant providers in Georgia →

Registry record

NPI: 1396455754
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Nov 2022
Record last updated: 28 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.