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General NPI Number Information
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NPI Number | 1619400579
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Entity Type | Organization
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Legal Business Name | BUSY BODY PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 1640 POWERS FERRY RD BLDG 19 STE 100
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City | MARIETTA
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State | GA
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Zip | 30067-5491
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Country | US
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Telephone | 678-304-9768
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 POWERS FERRY RD BLDG 19 STE 100
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City | MARIETTA
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State | GA
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Zip | 30067-5491
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Country | US
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Telephone | 678-304-9768
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BIANCA M REED
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Credential | OTR/L
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Telephone | 678-304-9768
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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 | OT005317
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License Number State | GA
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