MEDICARE: NICOLE LYNNE CARARA OTR/L

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		GA
2	225X00000X	Occupational Therapist	OT009773	GA

General Provider Information

NPI Number	:	1720885791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE LYNNE CARARA OTR/L

Provider Business Mailing Address
First Line	:	1690 ROSE MOSS CT SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-3969
Country	:	US
Telephone Number	:	301-275-4057
Fax Number	:	423-702-4493

Provider Business Practice Location Address
First Line	:	6896 RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-2337
Country	:	US
Telephone Number	:	301-275-4057
Fax Number	:	423-702-4493

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

Provider Enumeration Date	:	02/27/2025
Last Update Date	:	02/07/2026

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Directions to “ NICOLE LYNNE CARARA OTR/L” Practice Location

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