Individual
MS. JENNIFER AU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1244 CLAIRMONT RD, SUITE 224, DECATUR, GA 30030-1259
(404) 728-9766
(404) 728-9166
Mailing address
761 COMMONWEALTH AVE SE, ATLANTA, GA 30312-3660
(404) 728-9766
(404) 728-9166
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003439
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT003439
LICENSE NUMBER
GA
Enumeration date
09/21/2006
Last updated
07/09/2007
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