Provider Demographics
NPI:1811070659
Name:GAY, JOANNA DODSON (OTA)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:DODSON
Last Name:GAY
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5361 KINGS GAP RD
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:GA
Mailing Address - Zip Code:31826-2715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 POPLAR ST
Practice Address - Street 2:
Practice Address - City:IDEAL
Practice Address - State:GA
Practice Address - Zip Code:31041-6264
Practice Address - Country:US
Practice Address - Phone:478-949-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty