Provider Demographics
NPI:1205061652
Name:CARRINGTON, TARA M (MS OTR/L)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:M
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6170 STATE ROAD 70 E
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-9707
Mailing Address - Country:US
Mailing Address - Phone:941-224-5859
Mailing Address - Fax:
Practice Address - Street 1:6170 STATE ROAD 70 E
Practice Address - Street 2:SUITE 5
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-9707
Practice Address - Country:US
Practice Address - Phone:941-224-5859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12881225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist