Provider Demographics
NPI:1235349788
Name:FAUCHER, CAROLYN J (OTRL)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:J
Last Name:FAUCHER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HAZELNUT LN
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2600
Mailing Address - Country:US
Mailing Address - Phone:603-781-3428
Mailing Address - Fax:
Practice Address - Street 1:PROVIDENCE SEWARD MEDICAL CENTER
Practice Address - Street 2:1ST AVE
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-0365
Practice Address - Country:US
Practice Address - Phone:907-224-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003045225X00000X
NH1659225X00000X
AZ3597225X00000X
AK1759225X00000X
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist