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General NPI Number Information
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NPI Number | 1407311822
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Entity Type | Individual
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Provider Name | JAMIE LYNN NASH MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 165 RIDGECREST CIR
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City | CLAYTON
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State | GA
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Zip | 30525-4196
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Country | US
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Telephone | 678-357-5849
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Fax |
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Provider Business Mailing Address
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Address Line | 6232 RIVER PLANTATION DR
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City | LULA
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State | GA
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Zip | 30554-2382
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Country | US
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Telephone | 916-289-7854
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Fax |
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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 | OT007271
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License Number State | GA
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