Provider Demographics
NPI:1891502571
Name:NORTH, REICIA SYMONE (OTR/L)
Entity type:Individual
Prefix:
First Name:REICIA
Middle Name:SYMONE
Last Name:NORTH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 LAUADA DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-2421
Mailing Address - Country:US
Mailing Address - Phone:770-825-3846
Mailing Address - Fax:
Practice Address - Street 1:4004 LAUADA DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2421
Practice Address - Country:US
Practice Address - Phone:770-825-3846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics