Provider Demographics
NPI:1043829716
Name:HENNE, CARRIE NICOLE (OTA)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:NICOLE
Last Name:HENNE
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2532
Mailing Address - Country:US
Mailing Address - Phone:314-922-2388
Mailing Address - Fax:
Practice Address - Street 1:814 N PINE ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-2532
Practice Address - Country:US
Practice Address - Phone:314-922-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant