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Contact Information

KAITLIN LACKEY
105 GLENDALOUGH COURT
SUITE H
TYRONE, GA30290
 Phone: 678-632-6765
 Fax: 678-550-7931
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for KAITLIN LACKEY · (Female)

NPI Number 1407215361
Status Active
Credentials
Entity Individual
Enumeration date 02/19/2016
Last updated 02/19/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • GA License # OT006357
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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