Provider Demographics
NPI:1710261136
Name:MCFARLANE, DIANE E (OTR/L, MBA)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:E
Last Name:MCFARLANE
Suffix:
Gender:F
Credentials:OTR/L, MBA
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:E
Other - Last Name:MCFARLANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L, MBA
Mailing Address - Street 1:1125 BALTIC CT
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6762
Mailing Address - Country:US
Mailing Address - Phone:678-358-3841
Mailing Address - Fax:678-740-8821
Practice Address - Street 1:1125 BALTIC CT
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-6762
Practice Address - Country:US
Practice Address - Phone:678-358-3841
Practice Address - Fax:678-740-8821
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003342225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist