Provider Demographics
NPI:1811508674
Name:ANSARI, KAREN ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:ANSARI
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 1:7873 HARBOR MASTER CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8099
Mailing Address - Country:US
Mailing Address - Phone:859-512-6967
Mailing Address - Fax:
Practice Address - Street 1:931 N ASPEN ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-2113
Practice Address - Country:US
Practice Address - Phone:704-732-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13301225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist