Individual
MARILYN MARIE HORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1275 HIGHWAY 54 W STE 200, FAYETTEVILLE, GA 30214-4538
(770) 460-8609
(770) 460-8629
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 362-8684
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003637
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003637
LICENSE #
GA
Enumeration date
08/20/2006
Last updated
10/14/2016
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