Provider Demographics
NPI:1528538238
Name:KULIYEV, OKSANA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:OKSANA
Middle Name:
Last Name:KULIYEV
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 1:4720 PEACHTREE INDUSTRIAL BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:BERKELEY LAKE
Mailing Address - State:GA
Mailing Address - Zip Code:30071-5736
Mailing Address - Country:US
Mailing Address - Phone:470-317-7488
Mailing Address - Fax:317-436-1199
Practice Address - Street 1:4720 PEACHTREE INDUSTRIAL BLVD STE 103
Practice Address - Street 2:
Practice Address - City:BERKELEY LAKE
Practice Address - State:GA
Practice Address - Zip Code:30071-5736
Practice Address - Country:US
Practice Address - Phone:470-317-7488
Practice Address - Fax:317-436-1199
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006773A225X00000X
GAOT008524225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist