Provider Demographics
NPI:1235384777
Name:SPENCER, KAREN ALISON (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ALISON
Last Name:SPENCER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ALISON
Other - Last Name:LINCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:137 BERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13480-1102
Mailing Address - Country:US
Mailing Address - Phone:315-292-8980
Mailing Address - Fax:315-841-8985
Practice Address - Street 1:137 BERRILL AVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:NY
Practice Address - Zip Code:13480-1102
Practice Address - Country:US
Practice Address - Phone:315-292-8980
Practice Address - Fax:315-841-8985
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008066-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics