Provider Demographics
NPI:1467525899
Name:CHAFF, KARLA MICHELLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:MICHELLE
Last Name:CHAFF
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:KARLA
Other - Middle Name:MICHELLE
Other - Last Name:DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 RIVER PARK LN
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-5438
Mailing Address - Country:US
Mailing Address - Phone:404-593-3489
Mailing Address - Fax:404-288-7996
Practice Address - Street 1:22 RIVER PARK LN
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-5438
Practice Address - Country:US
Practice Address - Phone:404-593-3489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003206225XP0200X
SC5307225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000886476EMedicaid