Individual provider · NPI-1

Ebony Burroughs

Occupational Therapist · Buford, GA

NPI number1932898111
StatusActive
Last updated in NPPESJul 17, 2023

Details

NPI
1932898111
Entity type
Individual (NPI-1)
Name
Ebony Burroughs
Sex
Female
Sole proprietor
No
Enumeration date
May 3, 2023
Certification date
Jul 17, 2023
Last updated
Jul 17, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational TherapistOT008574GAYes

Practice location

4319 S Lee St Ste 300
Buford, GA 30518-5752

Phone 678-288-9770

Mailing address

2705 Mall Of Georgia Blvd Apt 904
Buford, GA 30519-8734

Phone 205-789-5310

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