Provider Demographics
NPI:1386977395
Name:SAUNDERS, CARRIE KRISTINE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:KRISTINE
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8720
Mailing Address - Country:US
Mailing Address - Phone:231-487-4638
Mailing Address - Fax:
Practice Address - Street 1:5293 GOKEE RD
Practice Address - Street 2:
Practice Address - City:BOYNE FALLS
Practice Address - State:MI
Practice Address - Zip Code:49713-9307
Practice Address - Country:US
Practice Address - Phone:231-348-6940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006619225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-6707Medicare PIN