Jamie Alane Goulet, MS, OTR/L

Individual provider Active NPI Occupational Therapist · Fort Eisenhower, GA

NPI 1972818409 · NPPES record last updated Apr 16, 2024

Key facts

NPI
1972818409
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT003659 (GA)
Practice address
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone
(706) 787-0463
NPI assigned
Aug 9, 2010
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT003659GAMDOccupational Therapist
OC010849PAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC010849 PA
Occupational Therapist 225X00000X OT003659 GA Yes

Addresses

Primary practice location

300 W Hospital Rd
Fort Eisenhower, GA 30905-5741

Mailing address

300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone (706) 787-0463

Other providers in Fort Eisenhower, GA

All providers in Fort Eisenhower, GA · Occupational Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.