Provider Demographics
NPI:1053320721
Name:ABBOTT, GEORGIA SUE (HTR)
Entity Type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:SUE
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:HTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5824 SW 24TH TER
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-1834
Mailing Address - Country:US
Mailing Address - Phone:785-273-2318
Mailing Address - Fax:
Practice Address - Street 1:5824 SW 24TH TER
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-1834
Practice Address - Country:US
Practice Address - Phone:785-273-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist