Individual
MRS. JESSICA N CAVALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1509 ATKINSON RD, SUITE 1100, LAWRENCEVILLE, GA 30043-7986
(770) 995-2379
(770) 995-2385
Mailing address
1509 ATKINSON RD, SUITE 1100, LAWRENCEVILLE, GA 30043-7986
(770) 995-2379
(770) 995-2385
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005183
GA
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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