Provider Demographics
NPI:1578704391
Name:VENABLE, EMILY DANIELLE (MHS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:DANIELLE
Last Name:VENABLE
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
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Mailing Address - Street 1:4939 LOWER ROSWELL RD
Mailing Address - Street 2:BLDG C, SUITE 201
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-4338
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4939 LOWER ROSWELL RD
Practice Address - Street 2:BLDG C, SUITE 201
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4338
Practice Address - Country:US
Practice Address - Phone:770-578-1519
Practice Address - Fax:770-578-0860
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAOT004079225X00000X, 225XE0001X, 225XF0002X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics