Carol Ann Avera, MS, OTR/L
Individual provider Active NPI Occupational Therapist · Pooler, GA
NPI 1215214341 · NPPES record last updated Mar 1, 2013
Key facts
- NPI
- 1215214341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT.4075OT (SC)
- Practice address
- 179 Spanton Cres
Pooler, GA 31322-9673 - Phone
- (912) 704-4277
- NPI assigned
- Nov 3, 2011
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT005162 | GA | MD | Occupational Therapist |
| OT.4075OT | SC | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT005162 | GA | |
| Occupational Therapist | 225X00000X | OT.4075OT | SC | Yes |
Addresses
Primary practice location
179 Spanton Cres
Pooler, GA 31322-9673
Mailing address
179 Spanton Cres
Pooler, GA 31322-9673
Phone (912) 704-4277
Other providers in Pooler, GA
- Atlantic Radiology Associates, LLC
- Atlas Physiotherapy, Inc
- Audiology Solutions
- Rhanita C Austin
- Alessandra Noelle Avena
- David Babbs
- Sharonda Bacon
- Jody Milford Baham
- Roger Aristotle Bailey
- Ma'Kayla Baldwin
All providers in Pooler, GA · Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.