Individual
TRACY MEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5150 STILESBORO RD NW, SUITE 430, KENNESAW, GA 30152-7744
(770) 218-2300
(770) 218-2201
Mailing address
5150 STILESBORO RD NW STE 210, KENNESAW, GA 30152-7742
(404) 384-3650
(786) 573-4809
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT004265
GA
225XP0200X
Pediatric Occupational Therapist
Primary
OT004265
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
877080133A
—
GA
Enumeration date
08/20/2008
Last updated
02/28/2022
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