Healthcare Provider Details

I. General information

NPI: 1821766254
Provider Name (Legal Business Name): MADELYN CRAIG OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8993 OKEECHOBEE BLVD UNIT 208
WEST PALM BEACH FL
33411-5144
US

IV. Provider business mailing address

8993 OKEECHOBEE BLVD
WEST PALM BEACH FL
33411-5144
US

V. Phone/Fax

Practice location:
  • Phone: 561-478-3702
  • Fax:
Mailing address:
  • Phone: 561-478-3702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT22287
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: