Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 000542 | GA |
NPI | 1073563771 |
---|---|
Provider Name | Mrs. Margaret Krengel |
First Address | Roswell, GA 30076-5720 |
Second Address | Roswell, GA 30076-5720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 05/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
67BBBKB | (02) | GA |
990037399H | (05) | GA |
GRP6544 | MEDICARE PTAN (01) | GA |