Provider Demographics
NPI:1164619581
Name:HEMMINGER, JONNA KAY
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:KAY
Last Name:HEMMINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JONNA
Other - Middle Name:KAY
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 NORTHWOODS PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-4708
Mailing Address - Country:US
Mailing Address - Phone:186-651-8175
Mailing Address - Fax:
Practice Address - Street 1:3000 NORTHWOODS PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-4708
Practice Address - Country:US
Practice Address - Phone:186-651-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057002656224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant