Individual
AMY MOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
6478 PUTNAM FORD DR STE 124, WOODSTOCK, GA 30189-6987
(678) 895-5223
(678) 550-7684
Mailing address
721 WAVELAND DR, WOODSTOCK, GA 30189-4222
(678) 895-5223
(678) 550-7684
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
004351
GA
225XP0200X
Pediatric Occupational Therapist
Primary
004351
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004351
OCCUPATIONAL THERAPY
GA
05
—
250330978G
—
GA
Enumeration date
12/04/2007
Last updated
08/31/2020
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