Provider Demographics
NPI:1750511895
Name:SUTTON, KARIE LYNN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:KARIE
Middle Name:LYNN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:KARIE
Other - Middle Name:LYNN
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2005 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43620-1703
Mailing Address - Country:US
Mailing Address - Phone:419-255-3040
Mailing Address - Fax:419-244-5569
Practice Address - Street 1:2005 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1703
Practice Address - Country:US
Practice Address - Phone:419-255-3040
Practice Address - Fax:419-244-5569
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA 02759224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant