Provider Demographics
NPI:1588600233
Name:MOHR, CAREY JO (OT)
Entity type:Individual
Prefix:
First Name:CAREY
Middle Name:JO
Last Name:MOHR
Suffix:
Gender:F
Credentials:OT
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 8028
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40257-8028
Mailing Address - Country:US
Mailing Address - Phone:502-693-2945
Mailing Address - Fax:502-897-2416
Practice Address - Street 1:221 NOTTING HILL BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-6271
Practice Address - Country:US
Practice Address - Phone:502-693-2945
Practice Address - Fax:502-897-2416
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2989225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9517Medicare ID - Type Unspecified