Provider Demographics
NPI:1558755330
Name:CARPENTER, CAITLIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 CENTER HILL RD
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-8829
Mailing Address - Country:US
Mailing Address - Phone:256-391-6616
Mailing Address - Fax:
Practice Address - Street 1:1784 ELKAHATCHEE RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-4800
Practice Address - Country:US
Practice Address - Phone:256-234-0592
Practice Address - Fax:256-234-7014
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3806225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist