Individual
DORA MCFADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1200 LAKE HEARN DR NE, ATLANTA, GA 30319-1415
(404) 943-1070
(678) 802-7334
Mailing address
5058 LAUREL BRIDGE DR SE, SMYRNA, GA 30082-4833
(770) 605-1429
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005402
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020063824
DRIVERS LICENSE
GA
Enumeration date
02/24/2012
Last updated
02/24/2012
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