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Individual

BERNADETTE JOAN DEWIT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2755 BUNTEN RD, DULUTH, GA 30096-4003
(678) 665-2926
Mailing address
150 FOAL DR, ROSWELL, GA 30076-3511
(678) 665-2926

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0001266
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10035430
AMERIGROUP
GA
01
308507
WELLCARE
GA
01
505898257B
PEACH STATE HEALTH PLAN
GA
05
505898257N
GA
Enumeration date
11/30/2006
Last updated
10/27/2025
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