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NPI Code Detail

MEDICARE: MRS. BERNADETTE B ALCALA MS OTR/L

MEDICARE:  MRS. BERNADETTE B ALCALA  MS 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
1225X00000XOccupational TherapistOT004865GA

General Provider Information

NPI Number : 1588800908
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BERNADETTE B ALCALA MS OTR/L
Provider Business Mailing Address
First Line : 4130 BAXTER TRL
Second Line :
City : SUWANEE
State : GA
Zip : 30024-8384
Country : US
Telephone Number : 678-765-0744
Fax Number :
Provider Business Practice Location Address
First Line : 5991 PARKWAY NORTH BLVD
Second Line : SUITE A
City : CUMMING
State : GA
Zip : 30040-1342
Country : US
Telephone Number : 770-205-5551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2009
Last Update Date : 01/07/2009

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Directions to “ MRS. BERNADETTE B ALCALA MS OTR/L” Practice Location

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