Healthcare Provider Details

I. General information

NPI: 1265123111
Provider Name (Legal Business Name): ANNA SABINA ARIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 KIMBERLY WAY STE 102
CANTON GA
30114-8009
US

IV. Provider business mailing address

3968 FELTON HILL RD SW STE 100
SMYRNA GA
30082-3522
US

V. Phone/Fax

Practice location:
  • Phone: 770-333-7888
  • Fax: 770-333-7889
Mailing address:
  • Phone: 770-333-7888
  • Fax: 770-333-7889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: