Provider Demographics
NPI:1841341419
Name:OJO, LAMURIEL Y (OTR)
Entity type:Individual
Prefix:
First Name:LAMURIEL
Middle Name:Y
Last Name:OJO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 1452
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:US
Mailing Address - Zip Code:31902
Mailing Address - Country:GE
Mailing Address - Phone:770-310-0510
Mailing Address - Fax:404-243-7928
Practice Address - Street 1:19 WALNUT CREEK LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-8157
Practice Address - Country:US
Practice Address - Phone:770-310-0510
Practice Address - Fax:404-341-9044
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001596225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000715008BMedicaid