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Individual

MRS. AMY DANIELLE DE LUISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1500 S JOHNSON FERRY RD NE, ATLANTA, GA 30319-1612
(404) 252-2002
Mailing address
4500 E SAM HOUSTON PKWY S, SUITE 215, PASADENA, TX 77505-3959
(281) 487-2786

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005028
GA

Other

Enumeration date
12/18/2009
Last updated
12/28/2010
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