Provider Demographics
NPI:1326471897
Name:CROSTHWAITE, GAIL Y (OTR)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:Y
Last Name:CROSTHWAITE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:PERALTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1333 WAIANUENUE AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1202
Mailing Address - Country:US
Mailing Address - Phone:808-934-2334
Mailing Address - Fax:
Practice Address - Street 1:1333 WAIANUENUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1202
Practice Address - Country:US
Practice Address - Phone:808-934-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist