Provider Demographics
NPI:1699211896
Name:GUIDA, JENA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:
Last Name:GUIDA
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:
Other - Last Name:GUIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:709 CRESCENT CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-4772
Mailing Address - Country:US
Mailing Address - Phone:844-543-8437
Mailing Address - Fax:844-543-8437
Practice Address - Street 1:1350 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-9110
Practice Address - Country:US
Practice Address - Phone:844-543-8437
Practice Address - Fax:844-543-8437
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006641225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist