Provider Demographics
NPI:1578636999
Name:NURHONEN, GILLIAN CJ (OTRL)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:CJ
Last Name:NURHONEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7635 ROCK SHADOW CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-7044
Mailing Address - Country:US
Mailing Address - Phone:678-513-3851
Mailing Address - Fax:678-513-3851
Practice Address - Street 1:7635 ROCK SHADOW CT
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-7044
Practice Address - Country:US
Practice Address - Phone:678-513-3851
Practice Address - Fax:678-513-3851
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003083225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003083OtherOCCUPATIONAL THER LICENSE