Provider Demographics
NPI:1275955940
Name:HENSLEY, CARRIE MARGARET (OCCUPATIONAL THERAPY)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:MARGARET
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 GRANDE BLVD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-7095
Mailing Address - Country:US
Mailing Address - Phone:330-723-8208
Mailing Address - Fax:
Practice Address - Street 1:5055 GRANDE BLVD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-7095
Practice Address - Country:US
Practice Address - Phone:330-723-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04063314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility