Provider Demographics
NPI:1700545506
Name:DEEM, CARLA (MA)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:DEEM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 N 5TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-1349
Mailing Address - Country:US
Mailing Address - Phone:813-361-4290
Mailing Address - Fax:
Practice Address - Street 1:1225 S MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5370
Practice Address - Country:US
Practice Address - Phone:724-217-8847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist