Carol J. Morehouse, OTR/L

Individual provider Active NPI Occupational Therapist · Bloomfield, NM

NPI 1033425152 · NPPES record last updated Aug 26, 2010

Key facts

NPI
1033425152
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2490 (NM)
Practice address
325 N Bergin LN
Bloomfield, NM 87413-6729
Phone
(505) 634-3946
Fax
(505) 634-3950
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2490NMMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2490 NM Yes

Addresses

Primary practice location

325 N Bergin LN
Bloomfield, NM 87413-6729

Mailing address

325 N Bergin LN
Bloomfield, NM 87413-6729
Phone (505) 634-3946

Other identifiers

IdentifierTypeStateIssuer
64434826MedicaidNM

Other providers in Bloomfield, NM

All providers in Bloomfield, NM · Occupational Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.