| Amy Catherine Wallace, OT | |
|
2920 Ronald Reagan Blvd, Ste 110, Cumming, GA 30041 | |
| (770) 889-0885 | |
| (770) 880-0886 |
| Full Name | Amy Catherine Wallace |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Hand |
| Location | 2920 Ronald Reagan Blvd, Cumming, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376695627 | NPI | - | NPPES |
| 899040116A | Medicaid | GA | |
| 1376695627 | Other | GA | BCBS |
| 611446156001 | Other | TRICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT004063 (Georgia) | Secondary |
| 225XH1200X | Occupational Therapist - Hand | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Catherine Wallace, OT 2920 Ronald Reagan Blvd, Ste 110, Cumming, GA 30041 Ph: (770) 889-0885 | Amy Catherine Wallace, OT 2920 Ronald Reagan Blvd, Ste 110, Cumming, GA 30041 Ph: (770) 889-0885 |
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