Sikithea Zackery, OTRL
Individual provider Active NPI Pediatric Occupational Therapist · Newnan, GA
NPI 1700928702 · NPPES record last updated Mar 18, 2016
Key facts
- NPI
- 1700928702
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- OT004099 (GA)
- Practice address
- 84 Lakeshore Parkway
Newnan, GA 30263 - Phone
- (678) 836-3083
- NPI assigned
- Feb 13, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| OT004099 | GA | MD | Pediatric Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT004099 | GA | Yes |
Addresses
Primary practice location
84 Lakeshore Parkway
Newnan, GA 30263
Mailing address
84 Lakeshore Pkwy
Newnan, GA 30263-2282
Phone (678) 836-3083
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 697269071B | Medicaid | GA |
Other providers in Newnan, GA
- Philip Charles Yarri Jr.
- Yolo Surgical Assisting LLC
- Nioka Young
- Shante Nicole Young
- Tameka Young
- Brian Stephenson Zeh
- Zion Taxi, LLC.
- George C Zubowicz
All providers in Newnan, GA · Pediatric Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.