Healthcare Provider Details

I. General information

NPI: 1407497167
Provider Name (Legal Business Name): LINDSAY G HURD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3597 KESWICK DR
ATLANTA GA
30341-2003
US

IV. Provider business mailing address

525 GLEN IRIS DR NE UNIT 2327
ATLANTA GA
30308-2973
US

V. Phone/Fax

Practice location:
  • Phone: 678-585-4715
  • Fax:
Mailing address:
  • Phone: 404-403-9502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT007501
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: