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Individual

ASMA A JUDDHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1949 HIGHWAY 81 STE 100, LOGANVILLE, GA 30052-4583
(770) 207-6390
Mailing address
1949 HIGHWAY 81 STE 100, LOGANVILLE, GA 30052-4583

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008155
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT008155
STATE OF GEORGIA
GA
Enumeration date
07/26/2021
Last updated
07/26/2021
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