Healthcare Provider Details

I. General information

NPI: 1841153525
Provider Name (Legal Business Name): ANDREA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 IRVIN ST
CORNELIA GA
30531-3567
US

IV. Provider business mailing address

335 IRVIN ST
CORNELIA GA
30531-3567
US

V. Phone/Fax

Practice location:
  • Phone: 770-820-4550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT009716
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: