Provider Demographics
NPI:1003229519
Name:DAVIS, KARIE
Entity Type:Individual
Prefix:
First Name:KARIE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 ROUTE 2
Mailing Address - Street 2:SUITE H
Mailing Address - City:HERMON
Mailing Address - State:ME
Mailing Address - Zip Code:04401-0665
Mailing Address - Country:US
Mailing Address - Phone:207-848-9009
Mailing Address - Fax:
Practice Address - Street 1:2402 ROUTE 2
Practice Address - Street 2:SUITE H
Practice Address - City:HERMON
Practice Address - State:ME
Practice Address - Zip Code:04401-0665
Practice Address - Country:US
Practice Address - Phone:207-848-9009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT670225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist