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Individual

MRS. JENNIFER VANDENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
78 OPAL ST, CARTERSVILLE, GA 30120-2848
(770) 382-6120
Mailing address
13 OVERLOOK CIR, EUHARLEE, GA 30145-2884
(678) 463-2810

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000964
GA

Other

Enumeration date
11/26/2012
Last updated
11/26/2012
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