Provider Demographics
NPI:1932410057
Name:EVANS, LALAH FARSHY (MHS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LALAH
Middle Name:FARSHY
Last Name:EVANS
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BATES AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-2601
Mailing Address - Country:US
Mailing Address - Phone:404-373-0699
Mailing Address - Fax:
Practice Address - Street 1:3160 NORTHSIDE PKWY NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1555
Practice Address - Country:US
Practice Address - Phone:404-233-5332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004089225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics