Individual
MS. JACQUELYN ALEXANDRA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5050 RESEARCH CT STE 800, SUWANEE, GA 30024-6606
(678) 749-7600
Mailing address
130 GENTRY GATE, JOHNS CREEK, GA 30022-6262
(404) 626-4985
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.013908
IL
225X00000X
Occupational Therapist
Primary
OT007913
GA
Other
Enumeration date
11/19/2020
Last updated
11/20/2020
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