Provider Demographics
NPI:1134684368
Name:CRAIGEN, AMY (MED, OTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CRAIGEN
Suffix:
Gender:F
Credentials:MED, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2087 THORNHILL DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5313
Mailing Address - Country:US
Mailing Address - Phone:330-785-6379
Mailing Address - Fax:
Practice Address - Street 1:2087 THORNHILL DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5313
Practice Address - Country:US
Practice Address - Phone:330-785-6379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04563225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist