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Contact Information

MARILYN J SMITH HAYNES, COTA, CAPS
3617 EBENEZER RD
MARIETTA, GA30066-2819
 Phone: 757-589-0864
 Fax: 770-805-0556
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
 

Environmental Modification

224ZE0001X
Indicates primary specialty

NPI Profile & details for MARILYN J SMITH HAYNES · (Female)

NPI # 1467816835
Status Active
Credentials COTA, CAPS
Entity Individual
Enumeration date 04/11/2016
Last updated 04/11/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # OTA000977
  • TX License # 213831
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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