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General NPI Number Information
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NPI Number | 1184789455
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Entity Type | Individual
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Provider Name | DAWN LACHANDRA JONES OTRL
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2759 MOUNT ZION PKWY STE A
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City | JONESBORO
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State | GA
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Zip | 30236-2568
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Country | US
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Telephone | 678-545-6745
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Fax | 678-489-7065
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Provider Business Mailing Address
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Address Line | 2759 MOUNT ZION PKWY STE A
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City | JONESBORO
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State | GA
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Zip | 30236-2568
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Country | US
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Telephone | 678-545-6745
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Fax | 678-489-7065
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT003694
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License Number State | GA
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