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General NPI Number Information
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NPI Number | 1386570133
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Entity Type | Organization
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Legal Business Name | MENDED MOTHER OT LLC
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Dates
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Enumeration Date | 06/19/2026
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Last Update Date | 06/19/2026
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Provider Practice Location Address
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Address Line | 821 N ST STE 102
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City | ANCHORAGE
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State | AK
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Zip | 99501-3285
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Country | US
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Telephone | 907-312-5564
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Fax |
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Provider Business Mailing Address
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Address Line | 821 N ST STE 102
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City | ANCHORAGE
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State | AK
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Zip | 99501-3285
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. CARRIE L PORTER
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Credential | OTD, OTR/L, COMT-UL
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Telephone | 915-539-0328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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