Provider Demographics
NPI:1114115722
Name:ROGERS, CRYSTAL BATES (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:BATES
Last Name:ROGERS
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 GREENO RD S
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-1902
Mailing Address - Country:US
Mailing Address - Phone:251-928-3909
Mailing Address - Fax:251-928-3984
Practice Address - Street 1:243 GREENO RD S
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1902
Practice Address - Country:US
Practice Address - Phone:251-928-3909
Practice Address - Fax:251-928-3984
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2114225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL631187140OtherTAX ID