Provider Demographics
NPI:1275158040
Name:TEMPLES, KAREN MILLSAP (OT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MILLSAP
Last Name:TEMPLES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 JORDAN RD SE
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-7813
Mailing Address - Country:US
Mailing Address - Phone:770-773-6453
Mailing Address - Fax:
Practice Address - Street 1:351 JORDAN RD SE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-7813
Practice Address - Country:US
Practice Address - Phone:770-773-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1280225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist