Individual
DEBORAH JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2140 BUFORD HWY, SUITE 208, BUFORD, GA 30518-6120
(678) 482-4554
Mailing address
531 SWEETFERN LN, SUGAR HILL, GA 30518-7612
(770) 271-2822
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT002402
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00977028A
—
GA
Enumeration date
11/16/2006
Last updated
07/08/2007
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