Provider Demographics
NPI:1679293153
Name:WALKER, TAISIA D (OTR)
Entity type:Individual
Prefix:
First Name:TAISIA
Middle Name:D
Last Name:WALKER
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 1:120 N LEE ST STE E
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-2122
Mailing Address - Country:US
Mailing Address - Phone:478-994-3390
Mailing Address - Fax:478-845-6252
Practice Address - Street 1:120 N LEE ST STE E
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2122
Practice Address - Country:US
Practice Address - Phone:478-994-3390
Practice Address - Fax:478-845-6252
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007668225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist