Provider Demographics
NPI:1497872667
Name:DUMAS, HARRIETT L (OTR L)
Entity Type:Individual
Prefix:MRS
First Name:HARRIETT
Middle Name:L
Last Name:DUMAS
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:MISS
Other - First Name:HARRIETT
Other - Middle Name:L
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR L
Mailing Address - Street 1:224 TROON W
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4949
Mailing Address - Country:US
Mailing Address - Phone:478-731-5235
Mailing Address - Fax:478-475-1010
Practice Address - Street 1:4501 RUSSELL PKWY
Practice Address - Street 2:SUITE 20
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088
Practice Address - Country:US
Practice Address - Phone:478-953-0077
Practice Address - Fax:478-475-1010
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT2530225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics