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General NPI Number Information
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NPI Number | 1316122062
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Entity Type | Individual
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Provider Name | CARRIE LEE PTACIN MS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 7990 E SNYDER RD APT 11101
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City | TUCSON
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State | AZ
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Zip | 85750-9022
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Country | US
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Telephone | 520-904-7812
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Fax |
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Provider Business Mailing Address
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Address Line | 7990 E SNYDER RD APT 11101
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City | TUCSON
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State | AZ
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Zip | 85750-9022
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Country | US
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Telephone | 520-904-7812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 3146
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License Number State | AZ
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