Provider Demographics
NPI:1881442267
Name:CARR, KRISTIN (OTD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15215 S 48TH ST UNIT 145
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-9142
Mailing Address - Country:US
Mailing Address - Phone:602-358-8148
Mailing Address - Fax:602-358-7994
Practice Address - Street 1:15215 S 48TH ST UNIT 145
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-9142
Practice Address - Country:US
Practice Address - Phone:602-358-8148
Practice Address - Fax:602-358-7994
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH009570225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist