Provider Demographics
NPI:1699176172
Name:DENISCO, CARA JEAN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:JEAN
Last Name:DENISCO
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 1:35 NANCY AVE
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2537
Mailing Address - Country:US
Mailing Address - Phone:978-836-8870
Mailing Address - Fax:
Practice Address - Street 1:15 KIRKBRIDE DR
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-6011
Practice Address - Country:US
Practice Address - Phone:978-716-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9724225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist