Basic Information
Provider Information
NPI: 1952557795
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGADO
FirstName: KARA-LYNN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: COTA/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1246 AMERICAN LEGION HWY
Address2:  
City: WESTPORT
State: MA
PostalCode: 027901195
CountryCode: US
TelephoneNumber: 7744881273
FaxNumber:  
Practice Location
Address1: 7540 N 19TH AVE
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850217967
CountryCode: US
TelephoneNumber: 8888734221
FaxNumber: 8885432289
Other Information
ProviderEnumerationDate: 08/12/2008
LastUpdateDate: 08/12/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X3100MAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


Home