Provider Demographics
NPI:1497942411
Name:AMMON-PLATT, CAROLINE LINDA (MPA, OT)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:LINDA
Last Name:AMMON-PLATT
Suffix:
Gender:F
Credentials:MPA, OT
Other - Prefix:
Other - First Name:CARO
Other - Middle Name:LINDA
Other - Last Name:AMMON-PLATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPA, OT
Mailing Address - Street 1:7916 BUTTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6461
Mailing Address - Country:US
Mailing Address - Phone:443-745-2177
Mailing Address - Fax:410-799-4561
Practice Address - Street 1:7916 BUTTERFIELD DR
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6461
Practice Address - Country:US
Practice Address - Phone:443-745-2177
Practice Address - Fax:410-799-4561
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02777171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor