Healthcare Provider Details

I. General information

NPI: 1215990882
Provider Name (Legal Business Name): CARRIE ANN BARTELME MS, OTR-L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4062 PEACHTREE RD NE STE A-123
BROOKHAVEN GA
30319-3021
US

IV. Provider business mailing address

4062 PEACHTREE RD NE STE A-123
BROOKHAVEN GA
30319-3021
US

V. Phone/Fax

Practice location:
  • Phone: 404-409-7099
  • Fax:
Mailing address:
  • Phone: 404-409-7099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT003448
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT003448
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: