Provider Demographics
NPI:1972937647
Name:BUTTLING, KAREN ELISABETH (COTA/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELISABETH
Last Name:BUTTLING
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BONNER DR
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1000
Mailing Address - Country:US
Mailing Address - Phone:518-744-6586
Mailing Address - Fax:
Practice Address - Street 1:29 BONNER DR
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1000
Practice Address - Country:US
Practice Address - Phone:518-744-6586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001744224Z00000X
DCOTA100000235224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant