Provider Demographics
NPI:1508455668
Name:CARABIN, ELLEN THERESE (OTR)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:THERESE
Last Name:CARABIN
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 1:5180 GLENMOORE WAY
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-6838
Mailing Address - Country:US
Mailing Address - Phone:330-635-8235
Mailing Address - Fax:
Practice Address - Street 1:806 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2128
Practice Address - Country:US
Practice Address - Phone:330-723-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011158225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist