Provider Demographics
NPI:1013282326
Name:JONES, PAULA ATRICE (OTR)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ATRICE
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:ATRICE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:17 PINE LANE DR
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-3668
Mailing Address - Country:US
Mailing Address - Phone:478-231-9439
Mailing Address - Fax:478-374-9673
Practice Address - Street 1:17 PINE LANE DR
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-3668
Practice Address - Country:US
Practice Address - Phone:478-231-9439
Practice Address - Fax:478-374-9673
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002020225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAOT002020OtherSTATE LICENSE