Provider Demographics
NPI:1205024270
Name:SAVAJA, HUMERA SHAMS (OTR)
Entity Type:Individual
Prefix:MRS
First Name:HUMERA
Middle Name:SHAMS
Last Name:SAVAJA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 RUNNYMEDE DR SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3368
Mailing Address - Country:US
Mailing Address - Phone:404-547-2027
Mailing Address - Fax:
Practice Address - Street 1:4000 RUNNYMEDE DR SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3368
Practice Address - Country:US
Practice Address - Phone:404-547-2027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004544225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist