Provider Demographics
NPI:1740523109
Name:MANAOIS, CARLA GAY ABAD (OTR/L)
Entity type:Individual
Prefix:
First Name:CARLA GAY
Middle Name:ABAD
Last Name:MANAOIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 THE MASTERS CV
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-6004
Mailing Address - Country:US
Mailing Address - Phone:478-745-9465
Mailing Address - Fax:
Practice Address - Street 1:770 BACONSFIELD DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-1400
Practice Address - Country:US
Practice Address - Phone:478-841-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004288225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics