Provider Demographics
NPI:1275869356
Name:PRESLEY, ERIN FORTENBERRY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:FORTENBERRY
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:FORTENBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:707 SPRING HEIGHTS LN SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6104
Mailing Address - Country:US
Mailing Address - Phone:770-714-3290
Mailing Address - Fax:
Practice Address - Street 1:3200 HIGHLANDS PKWY SE
Practice Address - Street 2:SUITE 150
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5166
Practice Address - Country:US
Practice Address - Phone:770-433-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004996225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist