Provider Demographics
NPI:1811783491
Name:WILHARM, CARLEY (OTR/L)
Entity type:Individual
Prefix:
First Name:CARLEY
Middle Name:
Last Name:WILHARM
Suffix:
Gender:
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 1:628 KESSLER DR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-4114
Mailing Address - Country:US
Mailing Address - Phone:920-716-4831
Mailing Address - Fax:
Practice Address - Street 1:2216 LESTER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2607
Practice Address - Country:US
Practice Address - Phone:505-296-4808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030111225X00000X
NMOT-2025-0074225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist