NPI Profile for SHARDAE PORTEE in LILBURN, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hand |
225XH1200X | 67 | Occupational Therapist in Private Practice |
| NPI Number | 1386185460 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/09/2017 | |
| Last updated | 11/15/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SHARDAE PORTEE
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