Healthcare Provider Details

I. General information

NPI: 1801368675
Provider Name (Legal Business Name): ACHIEVE OCCUPATIONAL THERAPY SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2018
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 ROSWELL RD STE 100
MARIETTA GA
30062-2980
US

IV. Provider business mailing address

2265 ROSWELL RD STE 100
MARIETTA GA
30062-2980
US

V. Phone/Fax

Practice location:
  • Phone: 770-509-2232
  • Fax: 770-509-2233
Mailing address:
  • Phone: 770-509-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NORMANIE MCKENZIE RICKS
Title or Position: OWNER
Credential: MS, OTR/L
Phone: 678-386-3172