Carolyn Carter

Individual provider Active NPI Occupational Therapy Assistant · Festus, MO

NPI 1144602467 · NPPES record last updated Jun 23, 2015

Key facts

NPI
1144602467
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
213215 (TX)
Practice address
101 Faulks LN
Festus, MO 63028-3547
Phone
(314) 435-0052
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

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
213215TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 213215 TX Yes

Addresses

Primary practice location

101 Faulks LN
Festus, MO 63028-3547

Mailing address

101 Faulks LN
Festus, MO 63028-3547

Other providers in Festus, MO

All providers in Festus, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.