Provider Demographics
NPI:1669218954
Name:CLAMP, KATELYN ELIZABETH HANKINSON (OTR/L)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ELIZABETH HANKINSON
Last Name:CLAMP
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:CLAMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:536 GRAND SLAM DR STE D
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-8045
Mailing Address - Country:US
Mailing Address - Phone:706-842-3330
Mailing Address - Fax:706-854-8435
Practice Address - Street 1:536 GRAND SLAM DR STE D
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-8045
Practice Address - Country:US
Practice Address - Phone:706-842-3330
Practice Address - Fax:706-854-8435
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT009211225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist