Healthcare Provider Details

I. General information

NPI: 1629072251
Provider Name (Legal Business Name): HELENE MCDOWELL OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2107 N DECATUR RD SUITE422
DECATUR GA
30033-5305
US

IV. Provider business mailing address

1237 SALEM GATE DRIVE
CONYERS GA
30655
US

V. Phone/Fax

Practice location:
  • Phone: 678-935-7357
  • Fax: 678-623-3292
Mailing address:
  • Phone: 770-922-3068
  • Fax: 770-922-6607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3303
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: