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NPI Code Detail

MEDICARE: ALYSSA CRUMP M.S., OTR/L

MEDICARE: ALYSSA CRUMP M.S., 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
1225X00000XOccupational TherapistBOTOCT00195833KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851791206
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA CRUMP M.S., OTR/L
Provider Business Mailing Address
First Line : 2520 REGENCY RD
Second Line : SUITE 150
City : LEXINGTON
State : KY
Zip : 40503-2921
Country : US
Telephone Number : 859-224-0834
Fax Number : 859-224-0882
Provider Business Practice Location Address
First Line : 2520 REGENCY RD
Second Line : SUITE 150
City : LEXINGTON
State : KY
Zip : 40503-2921
Country : US
Telephone Number : 859-224-0834
Fax Number : 859-224-0882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2014
Last Update Date : 04/25/2016

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