Provider Demographics
NPI:1619655636
Name:RASCIA, CARLY (OTD)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:RASCIA
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 N MARION ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1530
Mailing Address - Country:US
Mailing Address - Phone:844-478-6878
Mailing Address - Fax:844-478-6878
Practice Address - Street 1:718 N MARION ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1531
Practice Address - Country:US
Practice Address - Phone:844-478-6878
Practice Address - Fax:844-478-6878
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist