MEDICARE: KATHRYN CRAIG OTR

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
1	225X00000X	Occupational Therapist	2833-26	WI

General Provider Information

NPI Number	:	1447832324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN CRAIG OTR

Provider Business Mailing Address
First Line	:	240 MAPLE AVE
Second Line	:
City	:	MUKWONAGO
State	:	WI
Zip	:	53149-8475
Country	:	US
Telephone Number	:	262-363-1916
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 MAPLE AVE
Second Line	:
City	:	MUKWONAGO
State	:	WI
Zip	:	53149-8475
Country	:	US
Telephone Number	:	262-363-1916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2021
Last Update Date	:	01/19/2026

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