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Individual

MS. CARISSA CARPENTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
4603 TIMBERWALK CT, LA GRANGE, KY 40031-6746
(513) 309-5078
Mailing address
3064 FERGUSON RD FL 2, CINCINNATI, OH 45238-2434
(513) 309-5078

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
008550
OH
225X00000X
Occupational Therapist
Primary
262853
KY

Other

Enumeration date
02/15/2020
Last updated
07/13/2020
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