Healthcare Provider Details

I. General information

NPI: 1104749209
Provider Name (Legal Business Name): CAROLINE TORRANCE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 JESSE JEWELL PARKWAY SE STE 1A &1B
GAINESVILLE GA
30501-2613
US

IV. Provider business mailing address

2400 WISTERIA DR STE A
SNELLVILLE GA
30078-2689
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-9300
  • Fax: 770-536-9389
Mailing address:
  • Phone: 770-982-0102
  • Fax: 770-982-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT009907
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: