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Individual

MRS. DENISE WALZ VERMILYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2465 CANOPY GLN, MARIETTA, GA 30066-1541
(770) 517-2480
(770) 592-9431
Mailing address
PO BOX 670207, MARIETTA, GA 30066-0121
(770) 517-2480
(770) 592-9431

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0413
GA
225XP0200X
Pediatric Occupational Therapist
Primary
0413
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0413
OCCUPATIONAL THERPAY LICE
GA
05
643429152A
GA
Enumeration date
12/13/2006
Last updated
12/02/2011
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