Healthcare Provider Details

I. General information

NPI: 1306285648
Provider Name (Legal Business Name): AWRAIAL ELIZABETH BINNS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

3404 MARY LOU CT
AUGUSTA GA
30906-5062
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2482
  • Fax: 706-721-8168
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT005580
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: