Healthcare Provider Details

I. General information

NPI: 1235732991
Provider Name (Legal Business Name): CARRIE BEHRENDS OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 GALISTEO ST
SANTA FE NM
87505-4747
US

IV. Provider business mailing address

640 BEVERLY HILL BLVD.
BILLINGS MT
59102
US

V. Phone/Fax

Practice location:
  • Phone: 505-984-8313
  • Fax:
Mailing address:
  • Phone: 406-544-3926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-2024-0058
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberOT-2024-0058
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: