Provider Demographics
NPI:1629072251
Name:MCDOWELL, HELENE (OT)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:
Last Name:MCDOWELL
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 1:1237 SALEM GATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30655
Mailing Address - Country:US
Mailing Address - Phone:770-922-3068
Mailing Address - Fax:770-922-6607
Practice Address - Street 1:2107 N DECATUR RD
Practice Address - Street 2:SUITE422
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5305
Practice Address - Country:US
Practice Address - Phone:678-935-7357
Practice Address - Fax:678-623-3292
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3303225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000970868CMedicaid