Provider Demographics
NPI:1528600335
Name:MOBLEY, ARDEN CONSTANCE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ARDEN
Middle Name:CONSTANCE
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 JOHNSON FERRY PL STE G10
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2045
Mailing Address - Country:US
Mailing Address - Phone:770-321-6705
Mailing Address - Fax:
Practice Address - Street 1:1230 JOHNSON FERRY PL STE G10
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2045
Practice Address - Country:US
Practice Address - Phone:770-321-6705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007553225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist