Provider Demographics
NPI:1235387580
Name:DREITH, CAROL (OT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:DREITH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-4552
Mailing Address - Country:US
Mailing Address - Phone:325-236-6821
Mailing Address - Fax:325-236-6112
Practice Address - Street 1:114 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-4552
Practice Address - Country:US
Practice Address - Phone:325-236-6821
Practice Address - Fax:325-236-6112
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112762225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist