Provider Demographics
NPI:1497201479
Name:HALL, CAROLYN SUE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:SUE
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:S
Other - Last Name:REHM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2769 CLIFTON RD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2516
Mailing Address - Country:US
Mailing Address - Phone:614-284-8458
Mailing Address - Fax:
Practice Address - Street 1:1850 SUTTER PKWY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9168
Practice Address - Country:US
Practice Address - Phone:614-450-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH001065225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics