Provider Demographics
NPI:1851333801
Name:HUNT, RAGAN PAIGE (OT)
Entity Type:Individual
Prefix:
First Name:RAGAN
Middle Name:PAIGE
Last Name:HUNT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/CHT
Mailing Address - Street 1:1000 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE A-12
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2114
Mailing Address - Country:US
Mailing Address - Phone:404-367-2085
Mailing Address - Fax:770-579-7060
Practice Address - Street 1:1000 JOHNSON FERRY RD
Practice Address - Street 2:SUITE A-12
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2114
Practice Address - Country:US
Practice Address - Phone:404-367-2085
Practice Address - Fax:770-579-7060
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003771225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAOT003771OtherLICENSE NUMBER