Basic Information
Provider Information
NPI: 1770663098
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAREY
FirstName: DAWN
MiddleName: M
NamePrefix: MS.
NameSuffix:  
Credential: O.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 BLUE SPRUCE CT
Address2:  
City: REISTERSTOWN
State: MD
PostalCode: 211361303
CountryCode: US
TelephoneNumber: 4105267803
FaxNumber:  
Practice Location
Address1: 1026 CROMWELL BRIDGE RD
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212863308
CountryCode: US
TelephoneNumber: 4105831515
FaxNumber: 4105832491
Other Information
ProviderEnumerationDate: 10/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X02623MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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