Provider Demographics
NPI:1730320839
Name:HARPER, CAROLINE M
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:HARPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-8715
Mailing Address - Country:US
Mailing Address - Phone:417-753-3387
Mailing Address - Fax:417-334-2663
Practice Address - Street 1:1102 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-8715
Practice Address - Country:US
Practice Address - Phone:417-753-3387
Practice Address - Fax:417-334-2663
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004575225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist