Individual
NICOLE ADAIR MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
600 CHASTAIN RD NW STE 428, KENNESAW, GA 30144-3210
(770) 425-6701
(770) 425-6703
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 682-8840
(423) 602-2028
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
12293
NC
225X00000X
Occupational Therapist
Primary
OT008025
GA
Other
Enumeration date
02/11/2019
Last updated
04/29/2021
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