Provider Demographics
NPI:1942625322
Name:CARSONE, BLAIR (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:
Last Name:CARSONE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 PALMETTO DR
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-1354
Mailing Address - Country:US
Mailing Address - Phone:330-565-2884
Mailing Address - Fax:
Practice Address - Street 1:1144 PALMETTO DR
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1354
Practice Address - Country:US
Practice Address - Phone:330-565-2884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist