MEDICARE: MS. TAMMY RENEE MCKENZIE OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	OT10243	FL
2	225X00000X	Occupational Therapist	OT003249	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194719427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMMY RENEE MCKENZIE OTR/L

Provider Business Mailing Address
First Line	:	1390 US-76
Second Line	:
City	:	HIAWASSEE
State	:	GA
Zip	:	30546
Country	:	US
Telephone Number	:	850-524-2048
Fax Number	:

Provider Business Practice Location Address
First Line	:	1390 US-76
Second Line	:
City	:	HIAWASSEE
State	:	GA
Zip	:	30546
Country	:	US
Telephone Number	:	706-970-3551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	09/06/2024

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Directions to “ MS. TAMMY RENEE MCKENZIE OTR/L” Practice Location

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