Healthcare Provider Details

I. General information

NPI: 1841391067
Provider Name (Legal Business Name): CAROL ANN RUSHING-CARR MOT, OTR/L, BCP, CIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 W HIGH ST
MOUNT STERLING KY
40353-1328
US

IV. Provider business mailing address

318 W HIGH ST
MOUNT STERLING KY
40353-1328
US

V. Phone/Fax

Practice location:
  • Phone: 859-498-8647
  • Fax: 859-498-8677
Mailing address:
  • Phone: 859-498-8647
  • Fax: 859-498-8677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberR0059
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: