Individual
CARLY LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 MONTAUK HWY UNIT F, EAST MORICHES, NY 11940-1153
(631) 874-0571
Mailing address
21 PETERS DR, SHIRLEY, NY 11967-4215
(631) 300-6585
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
224Z00000X
Occupational Therapy Assistant
Primary
009846
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009846
OCCUPATIONAL THERAPY ASSISTANT LICENSE NUMBER
NY
01
—
405927
NBCOT
—
Enumeration date
08/21/2018
Last updated
06/21/2023
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