Individual
MS. CARRIE GRACE BAUMGARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
208 PENNKNOLL RD, EVERETT, PA 15537-6940
(814) 623-3240
Mailing address
603 W RACE ST, SOMERSET, PA 15501-1849
(814) 442-5495
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP001740L
PA
Other
Enumeration date
02/10/2013
Last updated
02/10/2013
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