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General NPI Number Information
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NPI Number | 1518179548
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Entity Type | Individual
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Provider Name | ALISHA MICHELLE WRIGHT OTRL
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 4370 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30319-3054
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Country | US
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Telephone | 404-799-4497
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Fax |
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Provider Business Mailing Address
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Address Line | 5489 PLATTE DR
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City | ELLENWOOD
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State | GA
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Zip | 30294-6668
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Country | US
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Telephone | 334-354-5120
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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 | OT003990
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License Number State | GA
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