Provider Demographics
NPI:1942339817
Name:O'HARA, CAROLYN ANNE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ANNE
Last Name:O'HARA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HAMPTON ROAD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4321
Mailing Address - Country:US
Mailing Address - Phone:603-772-2298
Mailing Address - Fax:
Practice Address - Street 1:50 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4813
Practice Address - Country:US
Practice Address - Phone:603-772-2298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03002255A2300X
MA17262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer