Provider Demographics
NPI:1609458579
Name:SWARMER, CARLY JANE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:JANE
Last Name:SWARMER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 N CALDWELL ST APT 2209
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-3602
Mailing Address - Country:US
Mailing Address - Phone:540-808-5427
Mailing Address - Fax:
Practice Address - Street 1:5820 CARMEL RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8106
Practice Address - Country:US
Practice Address - Phone:704-544-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14031224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant