Organization
JD OCCUPATIONAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA DUSSEAU OTR/L (OWNER)
(706) 424-4394
Entity
Organization
Contact information
Practice address
575 MAPLE FORGE DR, ATHENS, GA 30606-1173
(706) 424-4394
(866) 753-4652
Mailing address
575 MAPLE FORGE DR, ATHENS, GA 30606-1173
(706) 424-4394
(866) 753-4652
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005663
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT005663
STATE LICENSE
GA
Enumeration date
06/11/2015
Last updated
06/11/2015
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