Provider Demographics
NPI:1205221074
Name:WESTON, KAREN (OTR)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24260 RAYNAGUA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36551-7574
Mailing Address - Country:US
Mailing Address - Phone:251-604-2478
Mailing Address - Fax:
Practice Address - Street 1:24260 RAYNAGUA BLVD
Practice Address - Street 2:
Practice Address - City:LOXLEY
Practice Address - State:AL
Practice Address - Zip Code:36551-7574
Practice Address - Country:US
Practice Address - Phone:251-604-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2233225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation