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Individual

JENNA CATHERINE LUTHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
22 BUFORD VILLAGE WAY STE 229, BUFORD, GA 30518-8846
(670) 482-6100
(770) 932-5684
Mailing address
1512 TREE PARK CIR, FLOWERY BRANCH, GA 30542-2885
(727) 259-9325

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT007324
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
XXXXXX
GA
Enumeration date
03/14/2019
Last updated
03/14/2019
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