Provider Demographics
NPI:1295187904
Name:CARR, AMI LOUISE
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:LOUISE
Last Name:CARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 E EMERALD AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-5550
Mailing Address - Country:US
Mailing Address - Phone:865-524-7366
Mailing Address - Fax:865-637-4402
Practice Address - Street 1:809 E EMERALD AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-5550
Practice Address - Country:US
Practice Address - Phone:865-524-7366
Practice Address - Fax:865-637-4402
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2708224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant