Provider Demographics
NPI:1073918074
Name:JAMES, BEVERLY (OT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 LAUREL BROOK WAY
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-6489
Mailing Address - Country:US
Mailing Address - Phone:404-492-2336
Mailing Address - Fax:
Practice Address - Street 1:3835 LAUREL BROOK WAY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6489
Practice Address - Country:US
Practice Address - Phone:404-492-2336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist