Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | OT005289 | GA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT005289 |
NPI | 1033362496 |
---|---|
Provider Name | Jessica Marie Schaff |
First Address | Cumming, GA 30040-7396 |
Second Address | Cumming, GA 30040-8612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2008 |
Last Update Date | 15/04/2015 |