Provider Demographics
NPI:1891732285
Name:PRATT, PATRICIA NUSE (MOT, OTL)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:NUSE
Last Name:PRATT
Suffix:
Gender:F
Credentials:MOT, OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 TIMBERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-4082
Mailing Address - Country:US
Mailing Address - Phone:706-892-8400
Mailing Address - Fax:706-865-7715
Practice Address - Street 1:46 TIMBERLAKE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-4082
Practice Address - Country:US
Practice Address - Phone:706-892-8400
Practice Address - Fax:706-865-7715
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT000066225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0007302785OtherAETNA
GA52052808OtherBLUE CROSS/BLUE SHIELD GA