MEDICARE: CAROLINA HAND THERAPY SPECIALIST PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1205795010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA HAND THERAPY SPECIALIST PLLC

Provider Business Mailing Address
First Line	:	11425 FAIRES RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-8434
Country	:	US
Telephone Number	:	614-390-8049
Fax Number	:

Provider Business Practice Location Address
First Line	:	11425 FAIRES RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-8434
Country	:	US
Telephone Number	:	614-390-8049
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MARCIE SIEBERT
Credential	:	OT
Telephone Number	:	614-390-8049

Provider Enumeration Date	:	01/17/2026
Last Update Date	:	01/17/2026

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