Wallace, Amy Catherine

Wallace, Amy Catherine is an individual health care provider with primary practice located at 2920 Ronald Reagan Blvd Ste 110, Cumming GA 30041. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand is her primary health care specialty. Wallace, Amy Catherine can be contacted via phone (770) 889-0885.

Contact Information

Primary practice address
2920 Ronald Reagan Blvd Ste 110 Cumming GA 30041
Phone: (770) 889-0885
Fax: (770) 880-0886
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT004063 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand 225XH1200X

Profile Details

NPI number 1376695627
LBN Legal business name Wallace, Amy Catherine
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Dec 13th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376695627 NPPES
Georgia MEDICAID 899040116A
Georgia Other 1376695627
Georgia Other 611446156001

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