Individual
JENNIE NICHOLE STOKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1688 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30044-4608
(770) 995-2379
(770) 995-2385
Mailing address
1688 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30044-4608
(770) 995-2379
(770) 995-2385
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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