Provider Demographics
NPI:1992071690
Name:TALLEY, KAREN J (OTR/L)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:TALLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:J
Other - Last Name:WOOLPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-7877
Mailing Address - Country:US
Mailing Address - Phone:302-757-2964
Mailing Address - Fax:
Practice Address - Street 1:42 COTTAGE DR
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7877
Practice Address - Country:US
Practice Address - Phone:302-757-2964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC012221225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD292310OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY