Provider Demographics
NPI:1326347105
Name:MCWHORTER, KAREN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 BOWMAN MILL RD NE
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-7427
Mailing Address - Country:US
Mailing Address - Phone:770-307-5953
Mailing Address - Fax:
Practice Address - Street 1:139 BOWMAN MILL RD NE
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-7427
Practice Address - Country:US
Practice Address - Phone:770-307-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003011225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAOT003011OtherSTATE LICENSE GA