MEDICARE: CAROLINE INES 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	225X00000X	Occupational Therapist	006232	CT

General Provider Information

NPI Number	:	1790630994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE INES OTR/L

Provider Business Mailing Address
First Line	:	11 MCCLEAN AVE
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06905-3410
Country	:	US
Telephone Number	:	203-898-3579
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 HIGH RIDGE RD
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06905-3417
Country	:	US
Telephone Number	:	203-661-1609
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ CAROLINE INES OTR/L” Practice Location

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