Provider Demographics
NPI:1164007696
Name:MOTORVATE KIDS OT
Entity Type:Organization
Organization Name:MOTORVATE KIDS OT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLIE
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:843-685-6395
Mailing Address - Street 1:126 HAGAR BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-7024
Mailing Address - Country:US
Mailing Address - Phone:843-806-0878
Mailing Address - Fax:
Practice Address - Street 1:126 HAGAR BROWN RD
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7024
Practice Address - Country:US
Practice Address - Phone:843-685-6395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty