Provider Demographics
NPI:1932443397
Name:GARNER-HOUSTON, CAROL ELISE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ELISE
Last Name:GARNER-HOUSTON
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 1:151 REGIONS WAY
Mailing Address - Street 2:3D
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-5106
Mailing Address - Country:US
Mailing Address - Phone:850-200-4348
Mailing Address - Fax:
Practice Address - Street 1:151 REGIONS WAY
Practice Address - Street 2:3D
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-5106
Practice Address - Country:US
Practice Address - Phone:850-220-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-23
Last Update Date:2012-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 13046225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics