Provider Demographics
NPI:1508896390
Name:STALLINGS-SAHLER, SUSAN ACKER (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ACKER
Last Name:STALLINGS-SAHLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 OLD PETERSBURG RD
Mailing Address - Street 2:PETERSBURG PLAZA
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2865
Mailing Address - Country:US
Mailing Address - Phone:706-413-3136
Mailing Address - Fax:706-364-3470
Practice Address - Street 1:3624 OLD PETERSBURG RD
Practice Address - Street 2:PETERSBURG PLAZA
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-2865
Practice Address - Country:US
Practice Address - Phone:706-413-3136
Practice Address - Fax:706-364-3470
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003825225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAOT003825OtherOT LICENSE