Provider Demographics
NPI:1619685831
Name:GREER, HALLE (OTRL)
Entity Type:Individual
Prefix:
First Name:HALLE
Middle Name:
Last Name:GREER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:BOWERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30516-0084
Mailing Address - Country:US
Mailing Address - Phone:706-988-7412
Mailing Address - Fax:
Practice Address - Street 1:323 FRANKLIN SPRINGS ST
Practice Address - Street 2:
Practice Address - City:ROYSTON
Practice Address - State:GA
Practice Address - Zip Code:30662-4014
Practice Address - Country:US
Practice Address - Phone:706-981-9314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT008701225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist