Provider Demographics
NPI:1952883720
Name:SCHLEA, CARRIE LYNN
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LYNN
Last Name:SCHLEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11101 N COUNTY LINE HWY
Mailing Address - Street 2:
Mailing Address - City:BRITTON
Mailing Address - State:MI
Mailing Address - Zip Code:49229-9425
Mailing Address - Country:US
Mailing Address - Phone:419-350-0748
Mailing Address - Fax:
Practice Address - Street 1:4701 E HURON RIVER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105
Practice Address - Country:US
Practice Address - Phone:734-975-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
MI5201008167225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist