Taiwo Alonge

Individual provider Active NPI Occupational Therapy Assistant · Canton, GA

NPI 1013565746 · NPPES record last updated Aug 27, 2019

Key facts

NPI
1013565746
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA01767 (GA)
Practice address
150 Hospital Cir
Canton, GA 30114-3209
Phone
(770) 479-5649
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA01767GAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA01767 GA Yes

Addresses

Primary practice location

150 Hospital Cir
Canton, GA 30114-3209

Mailing address

150 Hospital Cir
Canton, GA 30114-3209

Other providers in Canton, GA

All providers in Canton, GA · Occupational Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.