Basic Information
Provider Information
NPI: 1811390982
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUTHRIE
FirstName: ARYN
MiddleName:  
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NameSuffix:  
Credential:  
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Mailing Information
Address1: 815 ATLANTA RD
Address2:  
City: CUMMING
State: GA
PostalCode: 300402707
CountryCode: US
TelephoneNumber: 6789470952
FaxNumber:  
Practice Location
Address1: 815 ATLANTA RD
Address2:  
City: CUMMING
State: GA
PostalCode: 300402707
CountryCode: US
TelephoneNumber: 6789470952
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/03/2014
LastUpdateDate: 10/03/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT005956GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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