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NPI Code Detail

MEDICARE: OLIVIA MULLEN OTD, OTR/L

MEDICARE: OLIVIA MULLEN OTD, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT009554GA

General Provider Information

NPI Number : 1134015100
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA MULLEN OTD, OTR/L
Provider Business Mailing Address
First Line : 11660 ALPHARETTA HWY STE 200
Second Line :
City : ROSWELL
State : GA
Zip : 30076-3874
Country : US
Telephone Number : 404-436-7416
Fax Number :
Provider Business Practice Location Address
First Line : 11660 ALPHARETTA HWY STE 200
Second Line :
City : ROSWELL
State : GA
Zip : 30076-3874
Country : US
Telephone Number : 404-436-7416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2025
Last Update Date : 06/16/2025

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Directions to “ OLIVIA MULLEN OTD, OTR/L” Practice Location

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