MEDICARE: KATHRYN CRICHTON OTR/L

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	003985	CT

General Provider Information

NPI Number	:	1730662081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN CRICHTON OTR/L

Provider Business Mailing Address
First Line	:	171 MAIN ST
Second Line	:
City	:	EAST WINDSOR
State	:	CT
Zip	:	06088-9682
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 MAIN ST
Second Line	:
City	:	EAST WINDSOR
State	:	CT
Zip	:	06088-9682
Country	:	US
Telephone Number	:	860-292-5394
Fax Number	:

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

Provider Enumeration Date	:	09/12/2018
Last Update Date	:	09/12/2018

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