Provider Demographics
NPI:1366817553
Name:GRANGE, KAREN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GRANGE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3697 KINGS ROW STE C
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1999
Mailing Address - Country:US
Mailing Address - Phone:775-400-2322
Mailing Address - Fax:
Practice Address - Street 1:3697 KINGS ROW STE C
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-1999
Practice Address - Country:US
Practice Address - Phone:775-400-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14-0435225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics