Provider Demographics
NPI:1689873515
Name:VALLOTTON, ALLISON M (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:VALLOTTON
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 1:3737 ROSCOMMON N
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4741
Mailing Address - Country:US
Mailing Address - Phone:706-860-9996
Mailing Address - Fax:706-868-7497
Practice Address - Street 1:3737 ROSCOMMON N
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-4741
Practice Address - Country:US
Practice Address - Phone:706-860-9996
Practice Address - Fax:706-868-7497
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002167225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10040552OtherAMERIGROUP
GA339901OtherWELLCARE