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Individual

MS. PATRICIA NUSE PRATT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MOT, OTL

Contact information

Practice address
46 TIMBERLAKE DR, CLEVELAND, GA 30528-4082
(706) 892-8400
(706) 865-7715
Mailing address
46 TIMBERLAKE DR, CLEVELAND, GA 30528-4082
(706) 892-8400
(706) 865-7715

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT000066
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007302785
AETNA
GA
01
52052808
BLUE CROSS/BLUE SHIELD GA
GA
Enumeration date
06/02/2006
Last updated
07/09/2007
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