Provider Demographics
NPI:1447322409
Name:SATTERLY, LINDA FAYE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:FAYE
Last Name:SATTERLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:TOWNSEND
Other - Last Name:SATTERLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:310 BLAKE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8515
Mailing Address - Country:US
Mailing Address - Phone:678-880-0189
Mailing Address - Fax:770-434-3999
Practice Address - Street 1:116 FORREST AVE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3640
Practice Address - Country:US
Practice Address - Phone:770-382-3206
Practice Address - Fax:770-382-3276
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003120225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10035982OtherAMERIGROUP
GA52047404 003OtherBLUE CROSS BLUE SHIELD
GA312666OtherWELLCARE
GA52047404 001OtherBLUE CROSS BLUE SHIELD
GA52047404 002OtherBLUE CROSS BLUE SHIELD