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General NPI Number Information
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NPI Number | 1871154096
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Entity Type | Individual
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Provider Name | MRS. KATHY M SHARPE
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Gender | Female
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Dates
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Enumeration Date | 06/27/2019
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 1514 CLEVELAND AVE STE 101
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City | ATLANTA
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State | GA
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Zip | 30344-6977
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Country | US
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Telephone | 888-322-8255
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Fax | 888-806-8549
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Provider Business Mailing Address
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Address Line | 876 BRISLEY CIR
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City | HAMPTON
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State | GA
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Zip | 30228-5950
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Country | US
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Telephone | 770-940-2347
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA02026
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License Number State | GA
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