MEDICARE: MS. KATHLEEN ANN CARLEY M.S. O.T.R. 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	872	MA

General Provider Information

NPI Number	:	1811043847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN ANN CARLEY M.S. O.T.R. L.

Provider Business Mailing Address
First Line	:	35 WATERSIDE RD # B
Second Line	:
City	:	MARBLEHEAD
State	:	MA
Zip	:	01945-1462
Country	:	US
Telephone Number	:	781-631-5572
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 CUMMINGS CTR
Second Line	:	SUITE 3850
City	:	BEVERLY
State	:	MA
Zip	:	01915-6142
Country	:	US
Telephone Number	:	978-232-0332
Fax Number	:	978-232-1103

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	10/17/2024

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