Individual
MRS. KATHY FRANCES BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4265 IRIS BROOKE LN, SNELLVILLE, GA 30039-8423
(770) 982-4496
(770) 982-4496
Mailing address
4265 IRIS BROOKE LN, SNELLVILLE, GA 30039-8423
(770) 982-4496
(770) 982-4496
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT000842
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10036231
AMERIGROUP PROVIDER NUMBE
GA
01
—
308956
WELLCARE PROVIDER NUMBER
GA
Enumeration date
11/12/2006
Last updated
07/09/2007
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