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General NPI Number Information
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NPI Number | 1457969214
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Entity Type | Individual
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Provider Name | MAKEIBA ALLEN MHS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1502 JONATHAN PL
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City | HEPHZIBAH
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State | GA
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Zip | 30815-6958
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Country | US
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Telephone | 888-531-2204
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Fax | 855-232-8604
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Provider Business Mailing Address
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Address Line | 1502 JONATHAN PL
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City | HEPHZIBAH
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State | GA
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Zip | 30815-6958
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Country | US
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Telephone | 888-531-2204
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Fax | 855-232-8604
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6098
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT004608
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License Number State | GA
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