Individual
TERRI DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5445 CASCADE RDG SW, ATLANTA, GA 30336-4433
(901) 517-9428
Mailing address
5445 CASCADE RDG SW, ATLANTA, GA 30336-4433
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT006640
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-0788059
TAX ID
GA
Enumeration date
04/09/2019
Last updated
04/09/2019
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