Provider Demographics
NPI:1609216977
Name:THOMPSON, CAROLYN ANN (OTR)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:3340 COLUMBINE DR
Mailing Address - Street 2:#707
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-2413
Mailing Address - Country:US
Mailing Address - Phone:970-556-4023
Mailing Address - Fax:
Practice Address - Street 1:3340 COLUMBINE DR
Practice Address - Street 2:#707
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-2413
Practice Address - Country:US
Practice Address - Phone:970-556-4023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001430225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist