NPI age
9 years
Enumerated 2017-05-04
● Active Type 2 · Organization
Fundamental Therapy Services, Llc
Fundamental Therapy Services, Llc is 1 of 3276 occupational therapist organizations in Georgia.
Primary specialty
Occupational Therapist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Deslich
Owner
Last NPPES update
2023-10-30
Source: monthly bulk 2026-05
How this organization compares
Across 3276 active occupational therapist providers in Georgia.
NPI age
9 years
≈ at median (9 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2017 → 2026
2017-05Enumerated in NPPES
2017
2026
Where they practice
Primary practice location
165 Ridgecrest Cir
Clayton, GA 305254110
Mailing address
4649 E Wolf Creek Rd
Tiger, GA 305762946
Authorized official
Jennifer Marie Deslich, MS, OTR/L
Owner
📞 6783575849
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Kaitlyn Howell, PT, DPT Physical Therapist NPI 1508602285
- Miranda Hunnicutt Speech-Language Pathologist NPI 1760960710
- Destiny Mangan, M.S. CCC-SLP Speech-Language Pathologist NPI 1245982289
- Jamie Nash, MS, OTR/L Occupational Therapist NPI 1407311822
- Kayla Parker, MS, OTR/L Occupational Therapist NPI 1851922231
- Anne Rickman, M.ED., CCC-SLP Speech-Language Pathologist NPI 1497389530
Specialties
-
Occupational Therapist PrimaryAn occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003141022E |
Practice context
Multi-provider organization. 6 individual providers on file at this primary address.
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