Provider Demographics
NPI:1114683182
Name:CRAWLEY, JYMEEKA (COTA/L)
Entity Type:Individual
Prefix:
First Name:JYMEEKA
Middle Name:
Last Name:CRAWLEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 WHITNEY DR APT 212
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-5088
Mailing Address - Country:US
Mailing Address - Phone:757-894-8700
Mailing Address - Fax:
Practice Address - Street 1:12230 ROUNDWOOD RD # MD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3233
Practice Address - Country:US
Practice Address - Phone:410-252-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02935224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant