Individual
MAMTA DAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2950 OLD ALABAMA RD, ALPHARETTA, GA 30022-8595
(770) 475-6622
Mailing address
5875 BAILEY RIDGE CT, DULUTH, GA 30097-1710
(770) 497-1617
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT001633
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT001633
OT LICENSE
GA
Enumeration date
04/29/2008
Last updated
04/29/2008
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