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NPI Code Detail

MEDICARE: KATIE WANG

MEDICARE: KATIE WANG
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
1225XP0200XPediatric Occupational TherapistOT009684GA

General Provider Information

NPI Number : 1174474779
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE WANG
Provider Business Mailing Address
First Line : 10745 BRUNSON DR
Second Line :
City : JOHNS CREEK
State : GA
Zip : 30097-8465
Country : US
Telephone Number : 770-542-8668
Fax Number :
Provider Business Practice Location Address
First Line : 2320 PERIMETER PARK DR
Second Line :
City : ATLANTA
State : GA
Zip : 30341-1317
Country : US
Telephone Number : 770-393-9901
Fax Number : 770-936-4601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ KATIE WANG ” Practice Location

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