Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 7637 | NC |
NPI | 1003231457 |
---|---|
Provider Name | Carissa Faye Crawford |
First Address | Charlotte, NC 28216-3068 |
Second Address | Charlotte, NC 28216-3068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2014 |
Last Update Date | 21/02/2014 |