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:
Health care specialties
Specialty | Code | License # | 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 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1376695627 | NPPES |
Georgia | MEDICAID | 899040116A | |
Georgia | Other | 1376695627 | |
Georgia | Other | 611446156001 |
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