Provider Demographics
NPI:1770143851
Name:KISEL, CARLA (OTR/L)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:KISEL
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 1:10 LOUELLA DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2675
Mailing Address - Country:US
Mailing Address - Phone:484-975-2330
Mailing Address - Fax:
Practice Address - Street 1:1515 THE FAIRWAY
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-1435
Practice Address - Country:US
Practice Address - Phone:215-885-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist