MEDICARE: ERIN NOLAN PATRICK MS, 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1902996978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN NOLAN PATRICK MS, OTR/L

Provider Business Mailing Address
First Line	:	1230 JOHNSON FERRY PL
Second Line	:	SUITE G-10
City	:	MARIETTA
State	:	GA
Zip	:	30068-2048
Country	:	US
Telephone Number	:	770-321-6705
Fax Number	:	404-551-3891

Provider Business Practice Location Address
First Line	:	1230 JOHNSON FERRY PL
Second Line	:	SUITE G-10
City	:	MARIETTA
State	:	GA
Zip	:	30068-2048
Country	:	US
Telephone Number	:	770-321-6705
Fax Number	:	404-551-3891

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	02/14/2017

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