Provider Demographics
NPI:1033877584
Name:MCCRADY, AMANDA R
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:R
Last Name:MCCRADY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2164 COPPER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-4731
Mailing Address - Country:US
Mailing Address - Phone:815-474-0343
Mailing Address - Fax:
Practice Address - Street 1:221 US HIGHWAY 41 STE H
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1278
Practice Address - Country:US
Practice Address - Phone:219-322-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist