Provider Demographics
NPI:1063535086
Name:HATNEY, GLORIA A (OTR)
Entity type:Individual
Prefix:MISS
First Name:GLORIA
Middle Name:A
Last Name:HATNEY
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 1:6850 GLEDHILL WAY
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-5414
Mailing Address - Country:US
Mailing Address - Phone:770-985-9050
Mailing Address - Fax:770-985-9223
Practice Address - Street 1:2386 CLOWER ST BLDG E SUITE 102
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6134
Practice Address - Country:US
Practice Address - Phone:770-985-9050
Practice Address - Fax:770-985-9223
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT000560225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist