Provider Demographics
NPI:1407938871
Name:BUTTON, CARRIE LYNNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LYNNE
Last Name:BUTTON
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 1:5 AVONDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1001
Mailing Address - Country:US
Mailing Address - Phone:607-382-1228
Mailing Address - Fax:
Practice Address - Street 1:84 GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:CANISTEO
Practice Address - State:NY
Practice Address - Zip Code:14823-1230
Practice Address - Country:US
Practice Address - Phone:607-698-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011828-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist