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General NPI Number Information
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NPI Number | 1003993684
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Entity Type | Individual
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Provider Name | DANIELLE ALYSSA PECORA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 335 PARKWAY 575 SUITE 100
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City | WOODSTOCK
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State | GA
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Zip | 30188-6433
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Country | US
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Telephone | 770-591-5852
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Fax | 770-591-5957
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Provider Business Mailing Address
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Address Line | 335 PARKWAY 575 SUITE 100
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City | WOODSTOCK
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State | GA
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Zip | 30188-6433
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Country | US
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Telephone | 770-591-5852
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Fax | 770-591-5957
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 002085
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License Number State | GA
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