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Individual

JENNIE NICHOLE STOKES

Active
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Individual

JENNIE NICHOLE STOKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
OT003787
GA
225XP0200X
Pediatric Occupational Therapist
Primary
OT003787
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10053517
GA
05
339551
GA
Enumeration date
11/30/2006
Last updated
09/25/2007
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