Provider Demographics
NPI:1710379763
Name:MEREDITH, GEORGIA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:
Last Name:MEREDITH
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 1:101 STONEHENGE CT
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7231
Mailing Address - Country:US
Mailing Address - Phone:501-499-1923
Mailing Address - Fax:
Practice Address - Street 1:101 STONEHENGE CT
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7231
Practice Address - Country:US
Practice Address - Phone:501-499-1923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1751225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist