Individual
SIKITHEA ZACKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
84 LAKESHORE PARKWAY, NEWNAN, GA 30263
(678) 836-3083
Mailing address
84 LAKESHORE PKWY, NEWNAN, GA 30263-2282
(678) 836-3083
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT004099
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
697269071B
—
GA
Enumeration date
02/13/2007
Last updated
03/18/2016
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