Angie R Hernandez, OTR/L

Individual provider Active NPI Occupational Therapist · Sugar Hill, GA

NPI 1477857134 · NPPES record last updated Jan 10, 2011

Key facts

NPI
1477857134
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT004533 (GA)
Practice address
569 Emerald Lake LN
Sugar Hill, GA 30518-5600
Phone
(678) 765-2920
NPI assigned
Jan 10, 2011
Sex
Female
Sole proprietor
Yes

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
OT004533GAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT004533 GA Yes

Addresses

Primary practice location

569 Emerald Lake LN
Sugar Hill, GA 30518-5600

Mailing address

569 Emerald Lake Lane
Sugar Hill, GA 30518

Other providers in Sugar Hill, GA

All providers in Sugar Hill, GA · Occupational Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.