Provider Demographics
NPI:1942940887
Name:PLETT, CAROLYN HALFORD (OTR)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:HALFORD
Last Name:PLETT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:MICHELLE
Other - Last Name:HALFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:9615 LIVENSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2853
Mailing Address - Country:US
Mailing Address - Phone:601-826-5613
Mailing Address - Fax:
Practice Address - Street 1:255 LEBANON RD
Practice Address - Street 2:STE 316
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036
Practice Address - Country:US
Practice Address - Phone:817-479-7019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122503225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist