Individual
PHENIX CARLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2384 DEBRA AVE, EAST PETERSBURG, PA 17520-1406
(717) 669-3690
Mailing address
2384 DEBRA AVE, EAST PETERSBURG, PA 17520-1406
(717) 669-3690
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC013944
PA
Other
Enumeration date
12/02/2015
Last updated
01/13/2026
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