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General NPI Number Information
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NPI Number | 1467578450
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Entity Type | Individual
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Provider Name | SHONDA LANKFORD HAYNES OTD, MS, MBA, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 229 RUGGED CREEK DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-4568
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Country | US
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Telephone | 251-284-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 229 RUGGED CREEK DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-4568
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Country | US
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Telephone | 251-284-8633
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Fax |
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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 | OT006440
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License Number State | GA
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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 | OT1536
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2156
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License Number State | AL
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