Healthcare Provider Details

I. General information

NPI: 1861738379
Provider Name (Legal Business Name): KAREN ASHWORTH LAMBERT OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 MCGINNIS FERRY RD BLDG.300, STE.302
ALPHARETTA GA
30005-3948
US

IV. Provider business mailing address

4080 MCGINNIS FERRY RD BLDG.300, STE.302
ALPHARETTA GA
30005-3948
US

V. Phone/Fax

Practice location:
  • Phone: 770-410-7719
  • Fax: 770-889-5584
Mailing address:
  • Phone: 770-410-7719
  • Fax: 770-889-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT002721
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT002721
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: