Provider Demographics
NPI:1699928259
Name:VON SCHENK, CAROLYN LEE (OT)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:LEE
Last Name:VON SCHENK
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 1:41 WERNER RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3409
Mailing Address - Country:US
Mailing Address - Phone:518-664-5066
Mailing Address - Fax:518-664-5728
Practice Address - Street 1:41 WERNER RD
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3409
Practice Address - Country:US
Practice Address - Phone:518-664-5066
Practice Address - Fax:518-664-5728
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002556-1225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics