Individual
STACY JACOBSON HEYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1104 BAILIFF CT NE, BROOKHAVEN, GA 30319-2665
(404) 409-6125
Mailing address
1104 BAILIFF CT NE, BROOKHAVEN, GA 30319-2665
(404) 409-6125
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT0003579
GA
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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