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General NPI Number Information
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NPI Number | 1750749842
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Entity Type | Individual
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Provider Name | ASHLEY POMERLEE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 2562 FAIRBURN RD D20
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-1461
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Country | US
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Telephone | 770-577-0399
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Fax | 678-922-1515
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Provider Business Mailing Address
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Address Line | 2145 LAKE PARK DR SE UNIT F
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City | SMYRNA
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State | GA
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Zip | 30080-8839
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT006361
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License Number State | GA
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