Individual
JENNIFER A DEMASTRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
570 W CROSSVILLE RD, ROSWELL, GA 30075-2694
(404) 414-7478
(470) 443-0767
Mailing address
404 AMBER WAY, WOODSTOCK, GA 30188-7414
(404) 414-7478
(470) 443-0767
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003507
GA
Other
Enumeration date
11/06/2007
Last updated
01/28/2020
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