Healthcare Provider Details

I. General information

NPI: 1184457921
Provider Name (Legal Business Name): MARGARET MARIE PIERSON RYDER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5660 LAKE FORREST DR
ATLANTA GA
30342-4635
US

IV. Provider business mailing address

2281 AKERS MILL RD SE APT 4711
ATLANTA GA
30339-2684
US

V. Phone/Fax

Practice location:
  • Phone: 404-500-9185
  • Fax:
Mailing address:
  • Phone: 404-791-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT008681
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: