Provider Demographics
NPI:1972377950
Name:CONWAY, APRIL DIANE (OTR/L)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:DIANE
Last Name:CONWAY
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 1:4652 CLIFDEN AVE
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-5238
Mailing Address - Country:US
Mailing Address - Phone:706-825-7853
Mailing Address - Fax:
Practice Address - Street 1:1103 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-3111
Practice Address - Country:US
Practice Address - Phone:706-721-9596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007148225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist