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Individual

CARRIE LEA GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
8031 W CENTER RD, SUITE 300, OMAHA, NE 68124-3158
(402) 391-5002
(402) 343-1278
Mailing address
8031 W CENTER RD, SUITE 300, OMAHA, NE 68124-3158
(402) 391-5002
(402) 343-1278

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
111657
TX
225XP0200X
Pediatric Occupational Therapist
Primary
001893
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001893
STATE LICENSURE
IA
01
111657
LICENSE
TX
Enumeration date
01/29/2007
Last updated
12/29/2010
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