Provider Demographics
NPI:1508126905
Name:HARRIS, CARIN LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:CARIN
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 S COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9712
Mailing Address - Country:US
Mailing Address - Phone:517-604-5399
Mailing Address - Fax:
Practice Address - Street 1:16405 NORTHCROSS DRIVE SUITE G-2
Practice Address - Street 2:HGI HEALTHCARE
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:866-214-9644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004143225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist