Individual
JENNIFER LYNN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3716 GATEWAY AVE, ALBANY, GA 31721-9247
(404) 821-6757
Mailing address
3716 GATEWAY AVE, ALBANY, GA 31721-9247
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001028
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA001028
OCCUPATIONAL THERAPY ASSISTANT LICENSE
GA
Enumeration date
07/12/2013
Last updated
07/12/2013
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