Provider Demographics
NPI:1376888198
Name:MCGEE, TERRANCE L (COTA)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:L
Last Name:MCGEE
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 CHIPWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8791
Mailing Address - Country:US
Mailing Address - Phone:678-583-6763
Mailing Address - Fax:
Practice Address - Street 1:504 CHIPWOOD CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8791
Practice Address - Country:US
Practice Address - Phone:678-583-6763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYOTA000417224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant