Provider Demographics
NPI:1528492527
Name:DAVIS, CARRIE T (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:T
Last Name:DAVIS
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:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:MOUNT TABOR
Mailing Address - State:NJ
Mailing Address - Zip Code:07878-0367
Mailing Address - Country:US
Mailing Address - Phone:201-926-8905
Mailing Address - Fax:
Practice Address - Street 1:5 TOWNSQUARE
Practice Address - Street 2:STE A
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2568
Practice Address - Country:US
Practice Address - Phone:201-926-8905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics