Individual
NIAJA DACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
530 PIEDMONT AVE NE, 905, ATLANTA, GA 30308-4415
(850) 585-0069
Mailing address
530 PIEDMONT AVE NE, 905, ATLANTA, GA 30308-4415
(850) 585-0069
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005820
GA
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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