Roberts, Vicki Maxwell

Roberts, Vicki Maxwell is an individual health care provider with primary practice located at 812 S Park St , Carrollton GA 30117-4412. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Roberts, Vicki Maxwell can be contacted via phone (770) 834-7436.

Contact Information

Primary practice address
812 S Park St Carrollton GA 30117-4412
Phone: (770) 834-7436
Fax: (770) 830-5954
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 000163 Georgia

Profile Details

NPI number 1477517662
LBN Legal business name Roberts, Vicki Maxwell
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Feb 28th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477517662 NPPES
Georgia MEDICAID 00564539B

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