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NPI Code Detail

MEDICARE: CHRISTINE FAYE CROW OTRL

MEDICARE: CHRISTINE FAYE CROW OTRL
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
1225XG0600XGerontology Occupational Therapist5201002341

General Provider Information

NPI Number : 1972072403
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE FAYE CROW OTRL
Provider Business Mailing Address
First Line : 21401 MACK AVE
Second Line :
City : GROSSE POINTE WOODS
State : MI
Zip : 48236-1048
Country : US
Telephone Number : 586-778-0800
Fax Number :
Provider Business Practice Location Address
First Line : 21401 MACK AVE
Second Line :
City : GROSSE POINTE WOODS
State : MI
Zip : 48236-1048
Country : US
Telephone Number : 586-778-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2018
Last Update Date : 11/14/2018

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Directions to “ CHRISTINE FAYE CROW OTRL” Practice Location

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