Individual
JESSICA GAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
195 14TH ST NE UNIT 708, ATLANTA, GA 30309-2673
(615) 478-6260
Mailing address
195 14TH ST NE UNIT 708, ATLANTA, GA 30309-2673
(615) 478-6260
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006599
GA
Other
Enumeration date
12/17/2017
Last updated
03/17/2018
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