Individual
MRS. MARY CATHERINE LODDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
1 MCGARITY RD, CANTON, GA 30115
(770) 360-9183
(770) 360-8965
Mailing address
3539 SUNDERLAND CIR NE, ATLANTA, GA 30319-1977
(678) 530-9518
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002757
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52212658-001
BLUE CROSS BLUE SHIELD
GA
Enumeration date
11/07/2006
Last updated
07/08/2007
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