Provider Demographics
NPI:1710668405
Name:CARTER, JANEA CHRISTINE (OT)
Entity Type:Individual
Prefix:
First Name:JANEA
Middle Name:CHRISTINE
Last Name:CARTER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JANEA
Other - Middle Name:CHRISTINE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:6412 MERRITT CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4735
Mailing Address - Country:US
Mailing Address - Phone:334-561-6488
Mailing Address - Fax:
Practice Address - Street 1:564 N MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-2132
Practice Address - Country:US
Practice Address - Phone:334-491-0066
Practice Address - Fax:334-491-0067
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6187225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics