Provider Demographics
NPI:1972133940
Name:CARRICK, ANNA TERESA (MOT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:TERESA
Last Name:CARRICK
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 BOXWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-8461
Mailing Address - Country:US
Mailing Address - Phone:440-319-9380
Mailing Address - Fax:
Practice Address - Street 1:15950 PIERCE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9577
Practice Address - Country:US
Practice Address - Phone:440-423-5787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-18
Last Update Date:2020-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist