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Individual

CHENG CHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
422 RENOWN CT, WINDER, GA 30680-4022
(678) 898-9404
Mailing address
5266 CAPAC RD, MUSSEY, MI 48014-1901

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002281
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1
MEDICARE
Enumeration date
03/15/2010
Last updated
08/28/2019
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