Provider Demographics
NPI:1851605968
Name:CARINO, KELLY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:CARINO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:TODD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 LEES AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2070
Mailing Address - Country:US
Mailing Address - Phone:607-846-1499
Mailing Address - Fax:
Practice Address - Street 1:24 LEES AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-2070
Practice Address - Country:US
Practice Address - Phone:607-846-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011494225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist