Organization
TAILORED OCCUPATIONAL THERAPY LLC
Active
Other names
TAILORED FOR TOTS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DANA L HARRIS OT (CEO)
(678) 637-7812
Entity
Organization
Contact information
Practice address
351 THORNTON RD STE 125, LITHIA SPRINGS, GA 30122-1589
(770) 577-0399
(678) 922-1515
Mailing address
PO BOX 943, AUSTELL, GA 30168-1053
(678) 637-7812
(678) 922-1515
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT001309
GA
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000683812C
—
GA
Enumeration date
11/30/2006
Last updated
03/11/2021
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