Individual
JENY ELSA ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1860 ATKINSON RD, LAWRENCEVILLE, GA 30043-5065
(706) 948-2773
Mailing address
159 OATGRASS DR, GRAYSON, GA 30017-4354
(770) 882-9314
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006891
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15818958
CAQH
GA
Enumeration date
12/15/2022
Last updated
12/15/2022
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