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NPI Code Detail

MEDICARE: MS. CRYSTAL DAWN MCCLIMANS

MEDICARE: MS. CRYSTAL DAWN MCCLIMANS
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
1224Z00000XOccupational Therapy Assistant

General Provider Information

NPI Number : 1962678078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CRYSTAL DAWN MCCLIMANS
Provider Business Mailing Address
First Line : 254 W BAY AVE APT 111
Second Line :
City : NORFOLK
State : VA
Zip : 23503-4569
Country : US
Telephone Number : 757-270-7854
Fax Number :
Provider Business Practice Location Address
First Line : 827 NORVIEW AVE
Second Line :
City : NORFOLK
State : VA
Zip : 23509-1540
Country : US
Telephone Number : 757-853-6281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2008
Last Update Date : 05/08/2008

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