Provider Demographics
NPI:1659538874
Name:MABRY, CARRIE (OT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MABRY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:STETSON
Mailing Address - State:ME
Mailing Address - Zip Code:04488-3101
Mailing Address - Country:US
Mailing Address - Phone:207-852-8438
Mailing Address - Fax:
Practice Address - Street 1:5 LONG LN STE 2
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1734
Practice Address - Country:US
Practice Address - Phone:207-619-1172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1818225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME414160099Medicaid