Provider Demographics
NPI:1407919731
Name:BEDICHEK, ABBY H (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:H
Last Name:BEDICHEK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 CROMERS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROYSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30662-3326
Mailing Address - Country:US
Mailing Address - Phone:706-491-0359
Mailing Address - Fax:888-831-1642
Practice Address - Street 1:613 COOK STREET
Practice Address - Street 2:
Practice Address - City:ROYSTON
Practice Address - State:GA
Practice Address - Zip Code:30662
Practice Address - Country:US
Practice Address - Phone:706-245-1822
Practice Address - Fax:706-245-1854
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004042225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist