Individual
MRS. JUDITH CARR ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1170 CASTLE DR, WATKINSVILLE, GA 30677-2292
(706) 296-6619
Mailing address
1170 CASTLE DR, WATKINSVILLE, GA 30677-2292
(706) 296-6619
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT000341
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT000341
GEORGIA STATE OCCUPATIONAL THERAPY LICENSE
GA
Enumeration date
05/21/2010
Last updated
05/21/2010
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