Healthcare Provider Details

I. General information

NPI: 1033362496
Provider Name (Legal Business Name): JESSICA MARIE SCHAFF OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5456 BETHELVIEW RD STE 103
CUMMING GA
30040-8612
US

IV. Provider business mailing address

7220 SCOTSHIRE WAY
CUMMING GA
30040-7396
US

V. Phone/Fax

Practice location:
  • Phone: 954-816-3130
  • Fax:
Mailing address:
  • Phone: 954-816-3130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT005289
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT005289
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: