Provider Demographics
NPI:1639474273
Name:FLOWERS, JESSICA WILLIAMS (OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:WILLIAMS
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 RIVERCREST DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-8349
Mailing Address - Country:US
Mailing Address - Phone:678-617-6726
Mailing Address - Fax:770-596-2045
Practice Address - Street 1:2925 RIVERCREST DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-8349
Practice Address - Country:US
Practice Address - Phone:678-617-6726
Practice Address - Fax:770-596-2045
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005195225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics