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NPI Code Detail

MEDICARE: MENDED MOTHER OT LLC

MEDICARE: MENDED MOTHER OT LLC
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1386570133
Entity Type Code : Organization
Provider Name (Legal Business Name) : MENDED MOTHER OT LLC
Provider Business Mailing Address
First Line : 821 N ST STE 102
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3285
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 821 N ST STE 102
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3285
Country : US
Telephone Number : 907-312-5564
Fax Number :
Authorized Official
Title or Position : FOUNDER
Name : DR. CARRIE L PORTER
Credential : OTD, OTR/L, COMT-UL
Telephone Number : 915-539-0328
Provider Enumeration Date : 06/19/2026
Last Update Date : 06/19/2026

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Directions to “MENDED MOTHER OT LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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