Most Relevant Information
Provider Data
| NPI Number: | 1003537556 |
| Provider Name: | DELISHA DANIEAL OFERRELL ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 405300000X |
| Specialty: | Prevention Professional |
| License Number: | AT001424 |
Most Important Dates
| Enumeration Date: | 09/02/2022 |
| Last Updated: | 09/02/2022 |
Provider Practice Location
3570 WHEELER RD
AUGUSTA
GA
309091893
Practice Location Phone/Fax
| Phone: | 7069229627 |
| Fax: |
Provider Mailing Location
3570 WHEELER RD
AUGUSTA
GA
309091893
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |