Healthcare Provider Details

I. General information

NPI: 1609636448
Provider Name (Legal Business Name): MAPP TO SUCCESS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 PENNSYLVANIA AVE
MCDONOUGH GA
30253-9110
US

IV. Provider business mailing address

7294 LAKE RUN CIR
STONE MOUNTAIN GA
30087-6363
US

V. Phone/Fax

Practice location:
  • Phone: 470-870-8729
  • Fax:
Mailing address:
  • Phone: 917-496-4631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NATARRA MAPP
Title or Position: CEO
Credential: OTR/L
Phone: 470-870-8729