Individual
ALYSSA E LUTHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
14A PROFESSIONAL CT SW, ROME, GA 30165-2832
(706) 624-3000
(706) 624-3001
Mailing address
263 HIGHWAY 53 E, CALHOUN, GA 30701-3026
(706) 624-3000
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT004674
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01158872
AMERIGROUP
GA
01
—
430957
WELLCARE
GA
01
—
52206285001
BLUE CROSS BLUE SHIELD
GA
05
—
874307047A
—
GA
Enumeration date
12/13/2007
Last updated
06/17/2010
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