Healthcare Provider Details

I. General information

NPI: 1336268341
Provider Name (Legal Business Name): DEANNA CRAIGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 13TH ST
HUNTINGTON WV
25701-1653
US

IV. Provider business mailing address

116 PRIVATE DRIVE 10461
PROCTORVILLE OH
45669-8027
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-7622
  • Fax: 304-529-1366
Mailing address:
  • Phone: 740-886-8728
  • Fax: 740-886-8728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1197
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: