Provider Demographics
NPI:1811581218
Name:CARNES, KAYLEY MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAYLEY
Middle Name:MARIE
Last Name:CARNES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1627
Mailing Address - Country:US
Mailing Address - Phone:201-327-4400
Mailing Address - Fax:201-327-3901
Practice Address - Street 1:106 IRVING ST NW STE 5000
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2981
Practice Address - Country:US
Practice Address - Phone:202-877-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09641225XH1200X
DCOT210002171225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ46TR00978000OtherOCCUPATIONAL THERAPY STATE LICENSE