Provider Demographics
NPI:1578897344
Name:ADAMS, CAROL A (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:ADAMS
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 1:714 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CLAY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67432-1833
Mailing Address - Country:US
Mailing Address - Phone:785-250-5150
Mailing Address - Fax:
Practice Address - Street 1:412 PARK ST
Practice Address - Street 2:BOX 219
Practice Address - City:GREENLEAF
Practice Address - State:KS
Practice Address - Zip Code:66943-9475
Practice Address - Country:US
Practice Address - Phone:785-747-7903
Practice Address - Fax:785-747-2606
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00376225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist