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NPI Code Detail

MEDICARE: JODIE CARLEY OTR/L

MEDICARE: JODIE CARLEY 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
1225X00000XOccupational Therapist
2225X00000XOccupational Therapist5201009117MI

General Provider Information

NPI Number : 1942695341
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODIE CARLEY OTR/L
Provider Business Mailing Address
First Line : 23948 CORA AVE
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48336-2624
Country : US
Telephone Number : 148-760-7543
Fax Number :
Provider Business Practice Location Address
First Line : 210 TOWN CENTER DR
Second Line :
City : TROY
State : MI
Zip : 48084-1774
Country : US
Telephone Number : 248-643-8900
Fax Number : 248-740-3505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2015
Last Update Date : 03/17/2018

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Directions to “ JODIE CARLEY OTR/L” Practice Location

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