Individual
RAE K. PENCEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3595 CANTON RD, SUITE A9 321, MARIETTA, GA 30066-2658
(770) 345-2804
(678) 827-0927
Mailing address
3595 CANTON RD, SUITE A9 321, MARIETTA, GA 30066-2658
(770) 345-2804
(678) 827-0927
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT003297
GA
Other
Enumeration date
02/19/2008
Last updated
02/19/2008
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