Provider Demographics
NPI:1033670872
Name:BURNS-ZANDERS, MARINDA (COTA/L)
Entity Type:Individual
Prefix:
First Name:MARINDA
Middle Name:
Last Name:BURNS-ZANDERS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4589 CHAFIN POINT CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-3378
Mailing Address - Country:US
Mailing Address - Phone:678-755-3362
Mailing Address - Fax:
Practice Address - Street 1:500 SPRINGHOUSE CIR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-6741
Practice Address - Country:US
Practice Address - Phone:770-879-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA002389224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant