Jamie Sue Allen, OTR/L

Individual provider Active NPI Occupational Therapist · Dacula, GA

NPI 1225313588 · NPPES record last updated Apr 7, 2020

Key facts

NPI
1225313588
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
3326 (AL)
Practice address
3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907
Phone
(678) 377-9634
Fax
(678) 377-9609
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3326ALMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3326 AL Yes

Addresses

Primary practice location

3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907

Mailing address

3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907
Phone (678) 377-9634

Other providers in Dacula, GA

All providers in Dacula, GA · Occupational Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.