Provider Demographics
NPI:1215168562
Name:MAYE, CARLA ELIZABETH (COTA/L)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ELIZABETH
Last Name:MAYE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-1016
Mailing Address - Country:US
Mailing Address - Phone:606-571-3478
Mailing Address - Fax:
Practice Address - Street 1:404 HARRISON ST
Practice Address - Street 2:
Practice Address - City:GREENUP
Practice Address - State:KY
Practice Address - Zip Code:41144-1016
Practice Address - Country:US
Practice Address - Phone:606-571-3478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA02346224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant