Provider Demographics
NPI:1629313036
Name:RASMUSSEN, RAMONA MORTON (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:RAMONA
Middle Name:MORTON
Last Name:RASMUSSEN
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 1:200 RIVERSTONE DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114
Mailing Address - Country:US
Mailing Address - Phone:770-345-7796
Mailing Address - Fax:770-479-3471
Practice Address - Street 1:200 RIVERSTONE DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114
Practice Address - Country:US
Practice Address - Phone:770-345-7796
Practice Address - Fax:770-479-3471
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT001951225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist