Healthcare Provider Details

I. General information

NPI: 1528432572
Provider Name (Legal Business Name): HILLARY OLIVIER WALTON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2015
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 PEACHTREE ST NE
ATLANTA GA
30309-7649
US

IV. Provider business mailing address

1005 BROOKSGLEN DR
ROSWELL GA
30075-1371
US

V. Phone/Fax

Practice location:
  • Phone: 570-854-1632
  • Fax:
Mailing address:
  • Phone: 504-343-7975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT006303
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: