Provider Demographics
NPI:1053682476
Name:SIMPSON, SHARLA MICHELLE (PTA)
Entity Type:Individual
Prefix:
First Name:SHARLA
Middle Name:MICHELLE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 14TH ST NE
Mailing Address - Street 2:#1403
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2671
Mailing Address - Country:US
Mailing Address - Phone:404-326-0065
Mailing Address - Fax:
Practice Address - Street 1:3161 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 410
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2135
Practice Address - Country:US
Practice Address - Phone:404-352-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA001994225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant