MEDICARE: MARIA GARCIA RUELAS OTD, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	225X00000X	Occupational Therapist	OT009507	GA

General Provider Information

NPI Number	:	1457900755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA GARCIA RUELAS OTD, OTR/L

Provider Business Mailing Address
First Line	:	2512 HOLLOW RIDGE DR
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-0365
Country	:	US
Telephone Number	:	209-684-6716
Fax Number	:

Provider Business Practice Location Address
First Line	:	4055 JOHNS CREEK PKWY
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-1299
Country	:	US
Telephone Number	:	770-888-5221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2019
Last Update Date	:	04/15/2026

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