Healthcare Provider Details

I. General information

NPI: 1548819196
Provider Name (Legal Business Name): READABLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4851 LULA ST NW
LILBURN GA
30047-3850
US

IV. Provider business mailing address

4851 LULA ST NW
LILBURN GA
30047-3850
US

V. Phone/Fax

Practice location:
  • Phone: 678-697-6049
  • Fax:
Mailing address:
  • Phone: 678-697-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. NANCY M CREWS
Title or Position: OWNER/OPERATOR
Credential: LCSW
Phone: 678-697-6049