Karsen Gwen Bleckley

Individual provider Active NPI Occupational Therapy Assistant · Clayton, GA

NPI 1326711599 · NPPES record last updated Jul 26, 2021

Key facts

NPI
1326711599
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA002206 (GA)
Practice address
547 Warwoman Rd
Clayton, GA 30525-5142
Phone
(706) 782-4276
NPI assigned
Jul 26, 2021
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
OTA002206GAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA002206 GA Yes

Addresses

Primary practice location

547 Warwoman Rd
Clayton, GA 30525-5142

Mailing address

PO Box 635
Clayton, GA 30525-0016
Phone (706) 982-4064

Electronic endpoints

TypeEndpointUseAffiliation
Other URL karsen.bleckley@c-ross.com Direct

Other providers in Clayton, GA

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

Sources for this page

Verify at the official NPI Registry.