Provider Demographics
NPI:1295836161
Name:HAMBY, JUDY RENE' (MHS, OTR/L, BCN)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:RENE'
Last Name:HAMBY
Suffix:
Gender:F
Credentials:MHS, OTR/L, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 COMMONS CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-3590
Mailing Address - Country:US
Mailing Address - Phone:678-494-5080
Mailing Address - Fax:
Practice Address - Street 1:5380 ROSWELL RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1916
Practice Address - Country:US
Practice Address - Phone:404-250-1680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT000990225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist