Healthcare Provider Details

I. General information

NPI: 1437360773
Provider Name (Legal Business Name): CRAWFORD THERAPEUTIC SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 CHARLES ALLEN DR NE APT 7
ATLANTA GA
30308-2081
US

IV. Provider business mailing address

706 CHARLES ALLEN DR NE APT 7
ATLANTA GA
30308-2081
US

V. Phone/Fax

Practice location:
  • Phone: 404-452-8843
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT00312
License Number StateGA

VIII. Authorized Official

Name: CLAIRE CRAWFORD
Title or Position: OT
Credential: OT
Phone: 404-452-8843