Healthcare Provider Details

I. General information

NPI: 1255925053
Provider Name (Legal Business Name): JANET CHAKKALAPADAVIL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANET BABU OTR/L

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
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

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

V. Phone/Fax

Practice location:
  • Phone: 470-612-2541
  • Fax: 404-882-0495
Mailing address:
  • Phone: 470-612-2541
  • Fax: 404-882-0495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT007987
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: