Provider Demographics
NPI:1699073536
Name:CARLOMAGNO, SHARON V (OT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:V
Last Name:CARLOMAGNO
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 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:8 W. NORRIS ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:NORRIS
Practice Address - State:TN
Practice Address - Zip Code:37828-1254
Practice Address - Country:US
Practice Address - Phone:865-494-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT226225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist