Healthcare Provider Details

I. General information

NPI: 1235364381
Provider Name (Legal Business Name): SABRINA D CRANOR NMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 BAINBRIDGE DR
MCDONOUGH GA
30253
US

IV. Provider business mailing address

422 BAINBRIDGE DR
MCDONOUGH GA
30253
US

V. Phone/Fax

Practice location:
  • Phone: 678-432-4755
  • Fax: 678-432-4753
Mailing address:
  • Phone: 678-432-4755
  • Fax: 678-432-4753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberNMT005737
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: