Provider Demographics
NPI:1386504728
Name:PRICE, JESSIE ELIZABETH FRYE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:ELIZABETH FRYE
Last Name:PRICE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-5620
Mailing Address - Country:US
Mailing Address - Phone:706-371-1059
Mailing Address - Fax:
Practice Address - Street 1:193 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-5620
Practice Address - Country:US
Practice Address - Phone:706-371-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007264225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics