Provider Demographics
NPI:1700260056
Name:MACNAMEE, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MACNAMEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 ROCKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6418
Mailing Address - Country:US
Mailing Address - Phone:561-702-0298
Mailing Address - Fax:
Practice Address - Street 1:1920 ROCKSIDE LN
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6418
Practice Address - Country:US
Practice Address - Phone:561-702-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005420225X00000X
FLOT 0004163225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist