Healthcare Provider Details
I. General information
NPI: 1205756947
Provider Name (Legal Business Name): OSMON PEDIATRIC THERAPY AND WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3195 BUFORD HWY STE 5&9
DULUTH GA
30096-5707
US
IV. Provider business mailing address
4015 LONGLAKE DR
DULUTH GA
30097-2220
US
V. Phone/Fax
- Phone: 678-467-3289
- Fax:
- Phone: 678-467-3289
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RABIA
SHAHBAZ
Title or Position: DIRECTOR
Credential: PHD
Phone: 678-467-3289