Provider Demographics
NPI:1912328287
Name:WISKIND, JANINE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:
Last Name:WISKIND
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 1:265 EDWARDTON CT
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3685
Mailing Address - Country:US
Mailing Address - Phone:678-643-0870
Mailing Address - Fax:
Practice Address - Street 1:265 EDWARDTON CT
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3685
Practice Address - Country:US
Practice Address - Phone:678-643-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT 003682225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist