Provider Demographics
NPI:1407442916
Name:MANNS, CARRIE ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:MANNS
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 1:12110 MORRIS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-1924
Mailing Address - Country:US
Mailing Address - Phone:775-367-6937
Mailing Address - Fax:
Practice Address - Street 1:12110 MORRIS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-1924
Practice Address - Country:US
Practice Address - Phone:813-431-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21151225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist