Provider Demographics
NPI:1760376354
Name:KINLEY, MADISON (OT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:KINLEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 PANTHER DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-5400
Mailing Address - Country:US
Mailing Address - Phone:706-367-1141
Mailing Address - Fax:706-932-0206
Practice Address - Street 1:510 PANTHER DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-5400
Practice Address - Country:US
Practice Address - Phone:706-870-6069
Practice Address - Fax:706-932-0206
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics