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Individual

MRS. AMBER JEAN CANTRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
4640 MARTIN RD, SUITE 300, CUMMING, GA 30041-5571
(678) 679-1261
(678) 679-1265
Mailing address
4640 MARTIN RD, SUITE 300, CUMMING, GA 30041-5571
(678) 679-1261
(678) 679-1265

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT005575
GA
225X00000X
Occupational Therapist
OT005575
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003128747A
GA
Enumeration date
10/25/2012
Last updated
08/28/2015
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