Provider Demographics
NPI:1285190611
Name:MCCARTNEY, KAREN MARIE (COTA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6356 GLENHURST DR APT 4
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-4143
Mailing Address - Country:US
Mailing Address - Phone:419-575-9621
Mailing Address - Fax:
Practice Address - Street 1:CHARTER OF OAK
Practice Address - Street 2:6805 SYLVANIA
Practice Address - City:SYLVAINIA
Practice Address - State:OH
Practice Address - Zip Code:43560
Practice Address - Country:US
Practice Address - Phone:877-514-4442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA06030224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant