Provider Demographics
NPI:1407290869
Name:GUNNELS, CAROLINE M (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:M
Last Name:GUNNELS
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 1:195 HIGHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6948
Mailing Address - Country:US
Mailing Address - Phone:845-569-4912
Mailing Address - Fax:
Practice Address - Street 1:278 ROUTE 32
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917-3226
Practice Address - Country:US
Practice Address - Phone:845-460-6065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-28
Last Update Date:2013-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013251225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist