Healthcare Provider Details

I. General information

NPI: 1417866633
Provider Name (Legal Business Name): RAIZEL BROWNSTEIN OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6075 THE CORNERS PKWY STE 105
NORCROSS GA
30092-3329
US

IV. Provider business mailing address

4755 ADAMS RD APT 520
DUNWOODY GA
30338-5222
US

V. Phone/Fax

Practice location:
  • Phone: 470-612-2541
  • Fax:
Mailing address:
  • Phone: 718-913-9627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010058
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: