Provider Demographics
NPI:1114267200
Name:DART, CAROLINE LOUISE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:LOUISE
Last Name:DART
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 1:65 LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-1225
Mailing Address - Country:US
Mailing Address - Phone:540-422-9595
Mailing Address - Fax:
Practice Address - Street 1:4937 SPRING RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NY
Practice Address - Zip Code:13478-3526
Practice Address - Country:US
Practice Address - Phone:315-361-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005956225X00000X, 225XP0200X
PATOC102589225X00000X
NY026466225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist