Provider Demographics
NPI:1912337510
Name:SEBASTIAN, KARLA MELISSA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:MELISSA
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:
Other - Last Name:SANTACAPITA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 601791
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1791
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4503 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4447
Practice Address - Country:US
Practice Address - Phone:910-721-3157
Practice Address - Fax:910-754-5577
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5255225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist