Provider Demographics
NPI:1497717367
Name:BEARD, KARI E (OT)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:E
Last Name:BEARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 WHITCHER ST NE
Mailing Address - Street 2:SUITE 1150
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1176
Mailing Address - Country:US
Mailing Address - Phone:678-594-4250
Mailing Address - Fax:770-423-2166
Practice Address - Street 1:61 WHITCHER ST NE
Practice Address - Street 2:SUITE 1150
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1176
Practice Address - Country:US
Practice Address - Phone:678-594-4250
Practice Address - Fax:770-423-2166
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002101225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP02031Medicare UPIN
GA67BBBCCMedicare ID - Type Unspecified