Provider Demographics
NPI:1881212124
Name:KING, NATALIE STONE (OTR/L, CBIS)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:STONE
Last Name:KING
Suffix:
Gender:F
Credentials:OTR/L, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 N AKIN DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3952
Mailing Address - Country:US
Mailing Address - Phone:706-506-2443
Mailing Address - Fax:
Practice Address - Street 1:1958 N AKIN DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3952
Practice Address - Country:US
Practice Address - Phone:706-506-2443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006589225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist