Provider Demographics
NPI:1851592539
Name:CARTER, AMY ELIZABETH (OTR)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15696 REBECCA LANE
Mailing Address - Street 2:
Mailing Address - City:L'ANSE
Mailing Address - State:MI
Mailing Address - Zip Code:49946
Mailing Address - Country:US
Mailing Address - Phone:906-424-4480
Mailing Address - Fax:
Practice Address - Street 1:303 BARAGA AVE
Practice Address - Street 2:
Practice Address - City:LANSE
Practice Address - State:MI
Practice Address - Zip Code:49946-1409
Practice Address - Country:US
Practice Address - Phone:906-524-6142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000064225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist