Provider Demographics
NPI:1306107651
Name:THORPE, CARRIE M (MOTR/L)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:M
Last Name:THORPE
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4987 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1249
Mailing Address - Country:US
Mailing Address - Phone:314-494-0818
Mailing Address - Fax:
Practice Address - Street 1:4987 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1249
Practice Address - Country:US
Practice Address - Phone:314-494-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010024586225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist