Individual
JENNIE CHAMBLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, OTM
Contact information
Practice address
6450 SPALDING DR, PEACHTREE CORNERS, GA 30092-4650
(847) 683-3628
Mailing address
1821 LAKEHURST CT SE, SMYRNA, GA 30080-3105
(404) 291-0042
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT007579
GA
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT007579
OT LICENSE
GA
Enumeration date
12/05/2019
Last updated
12/05/2019
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