MEDICARE: CAROL ORR

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1235524638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ORR

Provider Business Mailing Address
First Line	:	3601 E 11 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48092-2878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 E 11 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48092-2878
Country	:	US
Telephone Number	:	303-989-8169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2015
Last Update Date	:	11/25/2019

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Directions to “ CAROL ORR ” Practice Location

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