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Individual

GABRIEL MATIAH SMILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
141 SAMS ST, DECATUR, GA 30030-4115
(404) 296-8511
(404) 296-8514
Mailing address
141 SAMS ST, DECATUR, GA 30030-4115
(404) 296-8511
(404) 296-8514

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT009478
GA
225X00000X
Occupational Therapist
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15840
OT LICENSE
NC
Enumeration date
09/03/2020
Last updated
01/26/2026
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