=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407921182
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RASHEEDA LONNICE HASAN OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2006
-----------------------------------------------------
Last Update Date | 04/02/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 180 JACKSON ST NE APT 2206
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-454-8531
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 180 JACKSON ST NE APT 2206
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-454-8531
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT004035
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------