Provider Demographics
NPI:1427796275
Name:LAVEY, KARA LOUISE (OTA)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:LOUISE
Last Name:LAVEY
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13442 KLOPFENSTEIN RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9522
Mailing Address - Country:US
Mailing Address - Phone:419-367-2285
Mailing Address - Fax:
Practice Address - Street 1:3529 RIVERS EDGE DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1672
Practice Address - Country:US
Practice Address - Phone:419-874-2428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3097224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant