Provider Demographics
NPI:1548749393
Name:PERKINS, CASEY MILLER (COTA/L)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MILLER
Last Name:PERKINS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:RENEE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:675 OAK LEAF RD APT C
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-2425
Mailing Address - Country:US
Mailing Address - Phone:731-616-2338
Mailing Address - Fax:
Practice Address - Street 1:410 LAMBERT RD
Practice Address - Street 2:
Practice Address - City:BISCOE
Practice Address - State:NC
Practice Address - Zip Code:27209-9002
Practice Address - Country:US
Practice Address - Phone:910-428-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11753224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty