Provider Demographics
NPI:1740904028
Name:GREER-CARNEY, AUTUMN JOY (OT)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:JOY
Last Name:GREER-CARNEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:JOY
Other - Last Name:BOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:239 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7504
Mailing Address - Country:US
Mailing Address - Phone:603-224-6561
Mailing Address - Fax:
Practice Address - Street 1:239 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7504
Practice Address - Country:US
Practice Address - Phone:603-224-6561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3357225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty