Provider Demographics
NPI:1720274426
Name:HELVY, AMANI (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AMANI
Middle Name:
Last Name:HELVY
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 1:130 BENT ARROW DRIVE
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281
Mailing Address - Country:US
Mailing Address - Phone:248-796-1511
Mailing Address - Fax:
Practice Address - Street 1:4153 FLAT SHOALS PARKWAY
Practice Address - Street 2:BLDG C 300A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034
Practice Address - Country:US
Practice Address - Phone:770-407-9259
Practice Address - Fax:678-550-4207
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004606225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003124009CMedicaid