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NPI Code Detail

MEDICARE: CARLEEN ELIZABETH HINESLEY

MEDICARE:   CARLEEN ELIZABETH HINESLEY
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
1225X00000XOccupational TherapistOT006461GA

General Provider Information

NPI Number : 1720532963
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLEEN ELIZABETH HINESLEY
Provider Business Mailing Address
First Line : 2201 MOUNT ZION PKWY
Second Line :
City : MORROW
State : GA
Zip : 30260-3312
Country : US
Telephone Number : 844-543-8437
Fax Number :
Provider Business Practice Location Address
First Line : 2201 MOUNT ZION PKWY
Second Line :
City : MORROW
State : GA
Zip : 30260-3312
Country : US
Telephone Number : 844-543-8437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2016
Last Update Date : 11/17/2022

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Directions to “ CARLEEN ELIZABETH HINESLEY ” Practice Location

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