Healthcare Provider Details

I. General information

NPI: 1508126905
Provider Name (Legal Business Name): CARIN LYNN HARRIS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16405 NORTHCROSS DRIVE SUITE G-2 HGI HEALTHCARE
HUNTERSVILLE NC
28078
US

IV. Provider business mailing address

1655 S COLLEGE RD
MASON MI
48854-9712
US

V. Phone/Fax

Practice location:
  • Phone: 866-214-9644
  • Fax:
Mailing address:
  • Phone: 517-604-5399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201004143
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: