Healthcare Provider Details

I. General information

NPI: 1053180448
Provider Name (Legal Business Name): CARLY ELIZABETH METZLER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 124
LEONARDTOWN MD
20650-0124
US

IV. Provider business mailing address

PO BOX 124
LEONARDTOWN MD
20650-0124
US

V. Phone/Fax

Practice location:
  • Phone: 717-874-8714
  • Fax:
Mailing address:
  • Phone: 717-874-8714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC19694
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10302
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: