Provider Demographics
NPI:1972641280
Name:SCHMIDT, DEBBIE LYNN (OTRL)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:LYNN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 TUCKER HOLLOW RD SE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-3976
Mailing Address - Country:US
Mailing Address - Phone:706-602-9525
Mailing Address - Fax:706-624-3001
Practice Address - Street 1:263 HIGHWAY 53 E
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-3026
Practice Address - Country:US
Practice Address - Phone:706-624-3000
Practice Address - Fax:706-624-3001
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT001708225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA389259OtherWELLCARE
GA52635253004OtherBLUE CROSS/BLUE SHIELD
GA01045455OtherAMERIGROUP