Individual
MRS. DIANE CONSTANCE MCCLUSKEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3471 DEERFIELD LN NW, KENNESAW, GA 30144-1888
(770) 792-5986
(678) 290-0173
Mailing address
3471 DEERFIELD LN NW, KENNESAW, GA 30144-1888
(770) 792-5986
(678) 290-0173
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT002845
GA
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
OT002845
GA
225XP0200X
Pediatric Occupational Therapist
OT002845
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00907552A
—
GA
Enumeration date
04/26/2006
Last updated
09/11/2025
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