Kristen Palmer Hudgins, OTR/L

Individual provider Active NPI Occupational Therapist · Leary, GA

NPI 1669629705 · NPPES record last updated Apr 15, 2010

Key facts

NPI
1669629705
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT004381 (GA)
Practice address
196 Wildmeade Rd
Leary, GA 39862-3744
Phone
(229) 869-0891
Fax
(229) 869-0891
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
OT004381GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integra Rehabilitation Agency, LLC Past
since Nov 7, 2014
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT004381 GA Yes

Addresses

Primary practice location

196 Wildmeade Rd
Leary, GA 39862-3744

Mailing address

196 Wildmeade Rd
Leary, GA 39862-3744
Phone (229) 869-0891

Other providers in Leary, GA

All providers in Leary, GA · Occupational Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.