Provider Demographics
NPI:1871839266
Name:GARRINGTON, CARRIE SUE (COTA)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:SUE
Last Name:GARRINGTON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 DOLORES ST
Mailing Address - Street 2:APT 6
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-1153
Mailing Address - Country:US
Mailing Address - Phone:641-218-9585
Mailing Address - Fax:
Practice Address - Street 1:1718 DOLORES ST
Practice Address - Street 2:APT 6
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-1153
Practice Address - Country:US
Practice Address - Phone:641-218-9585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000955224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant